here - Antelope Valley District - Western Los Angeles County Council

here - Antelope Valley District - Western Los Angeles County Council

VENTURE CREW 3552
Antelope Valley District
Western Los Angeles County Council
Boy Scouts of America
3rd ANNUAL
CUBOREE 2016
Saturday May 28, 2016
“BRING A FRIEND TO SCOUTING”
Location: LDS Church 750 East Avenue J, Lancaster
Parents and leaders, now is the chance to show other boys in your community Scouting. Have your Scout
invite a friend to CUBOREE. This is a good opportunity for you to get other boys and parents interested in
Scouting. Have your guests enjoy the day with us at CUBOREE. Remember, this event is brought to you by
Venture Crew 3552 and other Boy Scout Troops of the Antelope Valley. They have worked hard to offer a
“Free” event for our Cub Scouts in the Valley. Please come and join us for the day. This will be a good time to
socialize and watch your Cubs working with each other and the Older Scouts.
Parents and leaders who stay will fill out an on-site form for their Cubs.
Parents who decide to leave their Cubs for the day, will need to fill out an off-site form.
This is in addition to permission slips and medical compliance.
WE WILL BE KEEPING A RATIO OF 10 CUBS PER LEADER
ALL CUB (Friends) AND BOY SCOUTS WILL USE THE BUDDY SYSTEM
As part of the registration process all adults who register their Cubs will receive a current cell phone
list of the Cuboree Leaders if requested.
The First Aid Station will be located near the registration area. Crew 3552 members have completed
the BSA Wilderness & Remote First Aid Course.
Restrooms are located inside the Church.
Participants will receive a CUBOREE patch.
Awards
1st,
2nd,
The patrols will be awarded ribbons for
& 3rd place. Other awards will be awarded.
The Event Monitors will be voting on their best choice for an outstanding Spirit Patrol/Cub Scout.
They will be awarded a special certificate.
One additional award will be for the: “Chuck-the-Chicken” Champion.
Registration
Registration forms are included in this information packet and will be available in the registration area
at Cuboree.
1.
2.
3.
4.
5.
Cub, unit & parent information – parent/leader present
Cub, unit & parent information – parent leaving
Statement of compliance for BSA Medical A&B requirement.
Firearms Permission Slip.
Activity Consent (permission) Form (BSA) – All Cub and Guests participating in Cuboree.
6. Activity Consent (permission) Form – Crew 3552 (for Boy Scouts who will be assisting at Cuboree.
Contact Information
Michaela Smith, Event Chair, Venture Crew / Den Chief, [email protected], 661579-6961 (evenings)
George Curtin, Venture Advisor, [email protected], 661-538-0195
VENTURE CREW 3552
Antelope Valley District
Western Los Angeles County Council
Boy Scouts of America
CUBOREE 2016
Saturday May 28, 2016
“BRING A FRIEND TO SCOUTING”
Welcome to the 3rd Annual CUBOREE 2016
Venture Crew 3552 (Chartered by Veterans of Foreign Wars Post 3552) with the help of the Boy
Scout Troops in the Antelope Valley are happy to provide a “FREE” event for Cub Scouts and their
friends. The Cubs and friends will compete in events to test their skills and coordination. In addition,
they will be working with local Boy Scout Troops who will be their Patrol Guide, manning the events
and judging the Cubs for Spirit.
Our Schedule is:
8:00am
9:00am
9:15am
9:30am
12 noon
1:00pm
4:00pm
4:30pm
Registration starts
Opening Ceremony
Brief rundown of events
Competition starts
Lunch (Cubs can have some 1 on 1 time with the Boy Scouts)
Competition events start
Competition ends (sooner if Cubs complete all events)
Awards Ceremony
Events planned: (other events may be added)
Land Skis
Hamster Race
Sack Race
Water Race
CAT-A-PULT
Balance Beam
Knots
Blind Scout
Donut Toss
Chuck-the Chicken
Cannon Ball Run
Wrist Rockets
Tug-O-War will take place at the end of the scheduled events. All participants, Boy Scouts, parents
and leaders are invited to join in. (this is to allow time for the Scouts to tally the scores and choose the
patrol with the best spirit and the Cub with the best spirit.
Scouts/Leaders/Parents will need to be sure to supply their own lunch/snacks.
CREW 3552 WILL BE PROVIDING BOTTLED WATER FOR EVERONE. (names will be written on the
bottles)
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VENTURE CREW 3552
Antelope Valley District
Western Los Angeles County Council
Boy Scouts of America
CUBOREE 2016
“BRING A FRIEND TO SCOUTING”
EVENT GUIDELINES
Chuck-the-Chicken
The chicken will be chucked into an area which will have rings designating the score earned.
The rings will vary in size. The available score rings will be: 50, 40, 30, 20 and if not in any of
the rings, 10 points. (like Skeeball scoring)
The score will be determined by where the tail of the chicken lies. If the tail is touching a
higher ring, that score will be given.
This event is twofold; one is for a Patrol event and an individual event. Total Patrol score will
be divided by the number of the Scouts in the Patrol for the average. Individual scores for the
boys will be recorded.
Land Skis
This is a timed event. The Cubs need to start, move forward to a designated area, turn around
and return to where they started. There will be two sizes of Land Skis for the Cubs. 4’ for
Tigers and Wolves, 6’ for Bears & Webelos.
Balance Beam
This is a timed event. The Cubs must traverse 3 beams that are 10 feet in length that will be
laid out in a Z pattern. Each time the Cub leaves the beam, 5 seconds will be added to the
total time. The total times will be averaged out by the amount of Cubs in the Patrol.
Water Race
This is a timed & amount event. The Cubs must use a sponge to take water from one bucket
to another bucket over a distance of approximately 50 feet. The amount of the water in the
second bucket will be recorded.
Sack Race
This is a timed event. Cubs must travel approximately 15 yards in a gunny sack.
Cat-A-Pult
This is a scored event. Cubs must catapult a bean filled cat backwards to a designated area.
They will be directed by another Cub in the Patrol.
Hamster Race
This is a timed event. The boys will be in a hamster type wheel and must get from the starting
line to the finish line working together.
Page 1 of 2
CUBOREE 2016
“BRING A FRIEND TO SCOUTING”
EVENT GUIDELINES
Cannon Ball Run
This is a timed event. The Patrol will use elevated PVC pipe to move a ball from start to finish.
The object is to use segments of pipe and roll the ball in the pipe by shifting positions of the
pipe to keep the ball rolling.
Wiffle Knock Out
This is a fun event. Patrol verses Patrol event. When an object is knocked down it eliminates
one of the other Patrol members.
Donut Toss
This is a scored event. The Patrol will use donut Frisbees to toss onto traffic cones. Scoring
will be determined by the distance the cones are spaced.
T-Flip
This is a timed event. The Patrol will be given an extra-large T-Shirt and they must transfer the
T-Shirt from one Scout to another.
Wrist Rockets
This will be a scored event. The Cubs will be given safety instructions; eye protection & be
monitored by a BSA trained Cub Scout Range Master (1 to 1 ratio). The Cubs will be given 5
rounds of ammunition to practice and another 5 rounds to get their best score.
Tug-O-War
This is an all-out battle between whoever wants to join. Could be the staff and parents.
During the Tug-O-War the staff will be tallying the Cubs scores and the Cubs Spirit points.
Page 2 of 2
Antelope Valley
CUBOREE 2016
Sponsored by Venture Crew 3552
“BRING A FRIEND TO SCOUTING”
Cub Information
Parent/Guardian Staying
Cub Scout Name: _____________________________________
“Bring a Friend” Name: ______________________________________
Pack Number: ___________
Rank: _________________
Age: ________________
Parents Name: _______________________________________________
Home #:______________________
Cell #:________________________
Alt. Name: ___________________________________________________
Alt. Phone: ____________________
Any concerns? _______________________________________________
Permission Slip Attached
Yes
No
Permission Slip Attached for “Bring a Friend”
Yes
No
Antelope Valley
CUBOREE 2016
Sponsored by Venture Crew 3552
“BRING A FRIEND TO SCOUTING”
Cub Information
Parent/Guardian Leaving
Tigers Must have a Parent or Guardian Present
Cub Scout Name: _____________________________________
“Bring a Friend” Name: ____________________________________
Pack Number: ___________
Rank: _________________
Age: ________________
Parents Name: _______________________________________________
Home #:______________________
Cell #:________________________
Alt. Name: ___________________________________________________
Alt. Phone: ____________________
Any concerns? _______________________________________________
Permission Slip Attached
Yes
No
Permission Slip Attached for “Bring a Friend”
Yes
No
VENTURE CREW 3552
Western Los Angeles County Council
Boy Scouts of America
CUBOREE 2016
“BRING A FRIEND TO SCOUTING”
Medical Statement
Cub Scout / Friend Name: _______________________________
I, ________________________________________ Parent/Guardian, Have [ ], Have not [ ], a BSA,
A&B form on file with my Pack.
Please List below any medical or personal problems or concerns that we will need to be aware of.
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
During the Cuboree our Council wishes for all participants to have a safe and fun time. If in the event
of an injury, all steps will be taken to prevent further injuries and get the medical attention that is
needed. First Aid station will be located next to the administration area.
Page 1 of 1
Antelope Valley District - WLACC
CUBOREE 2016
ACTIVITY CONSENT FORM AND APPROVAL BY PARENTS OR LEGAL GUARDIAN
FORMULARIO DE CONSENTIMIENTO Y APROBACIÓN DE ACTIVIDAD POR PARTE
DE LOS PADRES DE FAMILIA O TUTORES
The recommended use of this form is for the consent and approval
for Cub Scouts, Boy Scouts, Varsity Scouts, Venturers, and guests
to participate in a trip, expedition, or activity. It is required for use
with flying plans.
El uso recomendado de este formulario es para obtener el
consentimiento y aprobación para Cub Scouts, Boy Scouts, Varsity
Scouts, Venturers, e invitados para participar en un viaje, expedición
o actividad. Es obligatorio para su uso con planes de vuelo.
__________________________________________________________________________ _____________________ ___________________________________________________________________________
First name of participant
Middle initial
Last name
Nombre del participante
Inicial del segundo nombre
Apellido
Birth date (month/day/year) ____________________________________ /________________ /_____________________ Age during activity_____________
Fecha de nacimiento (mes/día/año) Edad al momento de realizar la actividad
____________________________________________________________________________________________________________________________________________________________________________________
Address
Domicilio
City________________________________________________________________________ State__________________________________________________Zip__________________
Ciudad
Estado
Código postal
5/28/16
5/28/16
Has approval to participate in (name of activity, orientation flight, outing trip, etc.)___________________________________________
DISTRICT CUBOREE 2016 From ______________ to ______________
Tiene la aprobación para participar en (nombre de la actividad, vuelo de orientación, excursión, etc.)
De
(Date)
a
(Date)
(fecha)
(fecha)
INFORMED CONSENT, RELEASE AGREEMENT, AND AUTHORIZATION
CONSENTIMIENTO INFORMADO, CONVENIO DE EXONERACIÓN Y AUTORIZACIÓN
I understand that participation in Scouting activities involves the risk of personal injury, including
death, due to the physical, mental, and emotional challenges in the activities offered. Information
about those activities may be obtained from the venue, activity coordinators, or local council. I also
understand that participation in these activities is entirely voluntary and requires participants to follow
instructions and abide by all applicable rules and the standards of conduct.
Entiendo que la participación en actividades Scouting implica el riesgo de lesiones personales, incluyendo la
muerte, debido a los retos físicos, mentales y emocionales en las actividades que se ofrecen. Se puede obtener
información sobre dichas actividades en la sede, con los coordinadores de la actividad o el concilio local.
También entiendo que la participación en estas actividades es totalmente voluntaria y requiere que los
participantes sigan instrucciones y acaten todas las reglas y normas de conducta pertinentes.
In case of an emergency involving my child, I understand that efforts will be made to contact me.
In the event I cannot be reached, permission is hereby given to the medical provider to secure proper
treatment, including hospitalization, anesthesia, surgery, or injections of medication for my child.
Medical providers are authorized to disclose protected health information to the adult in charge and/
or any physician or health care provider involved in providing medical care to the participant.
Protected Health Information/Confidential Health Information (PHI/CHI) under the Standards for
Privacy of Individually Identifiable Health Information, 45 C.F.R. §§160.103, 164.501, etc. seq., as
amended from time to time, includes examination findings, test results, and treatment provided
for purposes of medical evaluation of the participant, follow-up and communication with the
participant’s parents or guardian, and/or determination of the participant’s ability to continue in the
program activities.
En caso de que mi hijo se vea involucrado en una emergencia, entiendo que se realizarán esfuerzos para
contactarme. En caso de que yo no pueda ser localizado, por este medio otorgo permiso al proveedor de
servicios médicos para garantizar el tratamiento adecuado, incluyendo hospitalización, anestesia, cirugía o
inyecciones de medicamentos para mi hijo. Los proveedores de servicios médicos están autorizados a revelar
información médica protegida al adulto a cargo, médico o proveedor de servicios médicos involucrado en la
prestación de atención médica para el participante. La Información de salud protegida/Información médica
confidencial (PHI/CHI, por sus siglas en inglés) bajo los Estándares de privacidad de información médica
individualmente identificable, 45 C.F.R. §§ 160.103, 164.501, etc., y siguientes, como se enmiendan de vez en
cuando, incluyen resultados de reconocimientos médicos, resultados de pruebas y el tratamiento
proporcionado para fines de evaluación médica del participante, seguimiento y comunicación con los padres
o tutor legal del participante, o determinación de la capacidad del participante para continuar en las
actividades del programa.
With appreciation of the dangers and risks associated with programs and activities including
preparations for and transportation to and from the activity, on my own behalf and/or on behalf of my
child, I hereby fully and completely release and waive any and all claims for personal injury, death,
or loss that may arise against the Boy Scouts of America, the local council, the activity coordinators,
and all employees, volunteers, related parties, or other organizations associated with any program
or activity.
Con reconocimiento de los peligros y riesgos asociados con los programas y actividades incluyendo
preparativos y transportación hacia y desde la actividad, en mi propio nombre o en nombre de mi hijo, por
este conducto eximo total y completamente, y renuncio a cualquiera y toda reclamación por lesiones
personales, muerte o pérdidas que puedan surgir, a la organización Boy Scouts of America, el concilio local,
los coordinadores de la actividad y todos los empleados, voluntarios, grupos involucrados, u otras
organizaciones asociadas con cualquier programa o actividad.
NOTE: The Boy Scouts of America and local councils cannot continually monitor compliance of
program participants or any limitations imposed upon them by parents or medical providers. List any
restrictions imposed on a child participant in connection with programs or activities below and
counsel your child to comply with those restrictions.
NOTA: La organización Boy Scouts of America y los concilios locales no pueden vigilar continuamente el
cumplimiento de los participantes del programa o cualquier limitación impuesta sobre ellos por los padres o
proveedores de servicios médicos. Enumerar más abajo las restricciones impuestas a un niño participante
en relación con los programas o actividades.
List participant restrictions, if any:________________________________________________
None
Restricciones del participante, si existen: __________________________________________
Ninguna
______________________________________________________________________________________________________________________________________________________
Participant’s signature
Firma del participante
________________________
Date
Fecha
________________________________________________________________________
Parent/guardian printed name
Nombre con letra de molde del padre de familia/tutor
___________________________________________________________________________
Parent/guardian signature
Firma del padre de familia/tutor
________________________
Date
Fecha
________________________________________________________________________
rea code and telephone number (best contact and emergency contact)
A
Código de área y número telefónico (primer contacto y contacto de emergencia)
_________________________________________________________________________________________________________
Email (for use in sharing more details about the trip or activity)
Correo electrónico (para informar más detalles sobre el viaje o actividad)
Contact the adult leader with any questions:
Póngase en contacto con el líder adulto si es que tiene preguntas:
Name____________________________________________________________________Phone____________________________Email_________________________________________________________________
Nombre Teléfono
Correo electrónico
680-673
2014 Printing
Presented by: VENTURE CREW 3552
Western Los Angeles County Council
Antelope Valley District
Boy Scouts of America
Venture Crew 3552
Firearms Permission Slip
CALIFORNIA PENAL CODE SECTION 12552:
S 12552: Furnishing Firearms to Minors under 18 without permission of parent. --- Every person who
furnishes any firearm, air gun, or gas-operated gun, designed to fire a bullet, pellet, or metal
projectile, to any minor under the age of 18 years, without the express or implied permission of
the parent or legal guardian of the minor, is guilty of a misdemeanor.
By filling out the form below, I do hereby with full knowledge of the above statute expressly grant permission to
Venture Crew 3552, Western Los Angeles County Council, Boy Scouts of America and its employees, agents or
representatives to furnish to the below mentioned minor a firearm, air gun or gas operated gun of the nature and
type described in the above quoted section 12552 and may use same during the time said minor is at a Western
Los Angeles County Council Camp, a camp of another council, or Crew/Troop outing of the Boy Scouts of America.
This may include; Wrist Rockets, Slingshots, Catapults and other BSA approved Shooting devices.
Venture Crew 3552 will adhere to the BSA Guide to Safe Scouting, Shooting Sports Manual and the NRA
I,
Parent / Guardian, give permission for,
to use a firearm as described above.
Date of Event: May 28, 2016
End Date: May 28, 2016
Location of Event: CUBOREE-LDS Church 750 East Avenue J, Lancaster
Parent/Guardian Signature:
Date Signed:
Western Los Angeles County Council
Antelope Valley District
Boy Scouts of America
Venture Crew 3552
Firearms Permission Slip
CALIFORNIA PENAL CODE SECTION 12552:
S 12552: Furnishing Firearms to Minors under 18 without permission of parent. --- Every person who
furnishes any firearm, air gun, or gas-operated gun, designed to fire a bullet, pellet, or metal
projectile, to any minor under the age of 18 years, without the express or implied permission of
the parent or legal guardian of the minor, is guilty of a misdemeanor.
By filling out the form below, I do hereby with full knowledge of the above statute expressly grant permission to
Venture Crew 3552, Western Los Angeles County Council, Boy Scouts of America and its employees, agents or
representatives to furnish to the below mentioned minor a firearm, air gun or gas operated gun of the nature and
type described in the above quoted section 12552 and may use same during the time said minor is at a Western
Los Angeles County Council Camp, a camp of another council, or Crew/Troop outing of the Boy Scouts of America.
This may include; Wrist Rockets, Slingshots, Catapults and other BSA approved Shooting devices.
Venture Crew 3552 will adhere to the BSA Guide to Safe Scouting, Shooting Sports Manual and the NRA
I,
Parent / Guardian, give permission for,
to use a firearm as described above.
Date of Event: May 28, 2016
End Date: May 28, 2016
Location of Event: CUBOREE-LDS Church 750 East Avenue J, Lancaster
Parent/Guardian Signature:
Date Signed: