Camp La-No-Che

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Camp La-No-Che
Camp La-No-Che
The Leonard and Marjorie Williams Family
Scout Reservation
2013 Leader's Guide
Updated as 1of 2/4/2013
Table of Contents
Section I - Introduction and Summary............................................................................................... 6
Camp La-No-Che Highlights..............................................................................................................6
Reservations........................................................................................................................................6
Merit Badge Class Registration..........................................................................................................6
Facilities..............................................................................................................................................6
Communications................................................................................................................................. 6
Summer Camp Help............................................................................................................................ 7
Weeks of Summer Camp....................................................................................................................9
Policy Statement................................................................................................................................. 9
Scout Fees for Summer Camp............................................................................................................9
Traditional Camp................................................................................................................................9
Adventure Camp................................................................................................................................. 9
Camp Programs Offered...................................................................................................................10
Physical Exams................................................................................................................................. 10
Adventure Camps..............................................................................................................................10
Traditional Camp Troop Activities and Trails.......................................................................................10
Camperships...................................................................................................................................... 10
Provisional........................................................................................................................................ 10
Section II - Camp Schedules.......................................................................................................... 11
Scoutmaster and Senior Patrol Leader Meeting Schedule................................................................ 11
Sunday Schedule............................................................................................................................... 11
Monday - Friday Schedule................................................................................................................12
Saturday Schedule.............................................................................................................................12
Wave Groups.....................................................................................................................................12
Section III - Program Schedules....................................................................................................13
Merit Badge Records........................................................................................................................13
Merit Badge Not on Schedule...........................................................................................................13
Notes About Schedules.....................................................................................................................13
Adventure Camp...............................................................................................................................14
Troop Time Activities.......................................................................................................................14
Payment of Fees for Classes.............................................................................................................14
2013 Camp La-No-Che Merit Badge Schedule (sorted by Program Area).................................15-16
2013 Camp La-No-Che Merit Badge Schedule (sorted by Program Name)...............................17-18
Adventure Camp (for Scouts 13 years old or older).........................................................................19
Adventure Camp (for Scouts 11 years old or older).........................................................................20
Adventure Treks (for Scouts 13 years old or older)..........................................................................21
Aquatics.......................................................................................................................................22-23
Ecology.............................................................................................................................................24
Handicraft.........................................................................................................................................25
Healthcraft.........................................................................................................................................26
Native American...............................................................................................................................27
Scoutcraft..........................................................................................................................................28
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Shooting Sports.................................................................................................................................29
Skills.................................................................................................................................................30
Trailblazer Program..........................................................................................................................31
Trailblazer Schedule.........................................................................................................................31
Section IV - Traditional Camp Advanced Programs.....................................................................32
Advanced Sailing..............................................................................................................................32
Advanced Shooting Sports ...............................................................................................................32
Boardsailing, BSA ...........................................................................................................................32
Paul Bunyan Woodsman ..................................................................................................................32
S.C.U.B.A. Merit Badge ..................................................................................................................32
S.C.U.B.A. Advanced Diving ..........................................................................................................32
Slide Seat / Kayaking........................................................................................................................33
Venturing Adventure ........................................................................................................................ 33
Section V - Adventure Camps.......................................................................................................... 34
Project COPE ...................................................................................................................................34
Alpine Tower Adventure ..................................................................................................................34
Poseidon's Odyssey...........................................................................................................................34
Sea World Aquatics Adventure ........................................................................................................35
Additional Gear for Sea World Aquatic Adventure and Poseidon's Odyssey...................................35
Venturing / JROTC Ranger Camp....................................................................................................35
Attractions Tours .........................................................................................................................35-36
Custom Tours....................................................................................................................................36
Section VI - Trails, Activities, and Awards...................................................................................... 37
Conservation Challenge Program.....................................................................................................37
Hiker of La-No-Che Trails................................................................................................................37
Big Stump Trail ................................................................................................................................37
Cateye Trails ....................................................................................................................................37
Sulfur Springs Trail ..........................................................................................................................37
Trapper Creek Nature Trail ..............................................................................................................37
Mile Run ..........................................................................................................................................38
Mile Swim, BSA ..............................................................................................................................38
Order of the Arrow ........................................................................................................................... 38
Conservation Projects ......................................................................................................................38
Service Projects ................................................................................................................................38
Troop Snack Social ..........................................................................................................................38
Troop Ice Cream Social ...................................................................................................................38
Troop Pizza Social ...........................................................................................................................38
Troop Shoot ......................................................................................................................................38
Troop Rowing ..................................................................................................................................39
Troop Sailing ....................................................................................................................................39
Troop Swim ......................................................................................................................................39
Snorkeling, BSA ..............................................................................................................................39
Totin’ Chip / Firem’n Chit ...............................................................................................................39
Campwide Games ............................................................................................................................39
Troop Volleyball Tournament ..........................................................................................................39
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Troop Basketball Tournament .........................................................................................................39
Trail Bike Adventure ........................................................................................................................39
Custom Troop Activities ..................................................................................................................39
Commissioner’s Awards ..................................................................................................................40
Summer Camp Patch ........................................................................................................................40
World Conservation Award ..............................................................................................................40
Sports................................................................................................................................................ 40
Gateway Competition ......................................................................................................................40
Patrol Flag Competition ...................................................................................................................40
Section VII - Leader Information...................................................................................................41
Adult Leadership in Camp................................................................................................................41
Scout Leadership in Camp ...............................................................................................................41
Camperships .....................................................................................................................................41
Orientation Meeting .........................................................................................................................41
Troop Time Signup...........................................................................................................................41
Out of Council Troops......................................................................................................................41
Scout Fees ........................................................................................................................................41
Leader Fees.......................................................................................................................................41
Additional Free Leader Program .....................................................................................................42
Methods of Payment ........................................................................................................................42
Fee Payment Schedule .....................................................................................................................42
Proof of Insurance ............................................................................................................................42
Access Statement .............................................................................................................................42
Camp Meetings ................................................................................................................................43
Photos................................................................................................................................................43
Mail ..................................................................................................................................................43
Email.................................................................................................................................................43
Telephone .........................................................................................................................................43
Water and Ice ...................................................................................................................................43
Emergencies .....................................................................................................................................44
Weather ............................................................................................................................................44
Medical Services ..............................................................................................................................44
Valuables ..........................................................................................................................................44
Family Participation Night ...............................................................................................................45
Vehicles.............................................................................................................................................45
Trading Post .....................................................................................................................................45
Uniform at Camp..............................................................................................................................45
Religious Observance ......................................................................................................................45
Supplies ............................................................................................................................................45
Safety Rules .....................................................................................................................................45
Check-In Procedure..........................................................................................................................46
Camp Preparation Checklist for Camp Leaders ...............................................................................46
Boy Scouts of America Smoke-Free Policy .....................................................................................46
Meal Service.....................................................................................................................................47
Adult Leader Program.......................................................................................................................47
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Fishing..............................................................................................................................................47
Horseshoe Tournament ....................................................................................................................47
Adventure Camp ..............................................................................................................................47
Safe Swim Defense and Safety Afloat .............................................................................................47
Scoutmaster Dinner ..........................................................................................................................48
Scoutmaster Meeting .......................................................................................................................48
Skeet Shoot ......................................................................................................................................48
Night Owl Adventure .......................................................................................................................48
Climb on Safely................................................................................................................................48
Climbing Certification......................................................................................................................48
Woodsman 1 & 2 .............................................................................................................................48
Section VIII - Provisional Camping...............................................................................................50
La-No-Che Provisional Troop..........................................................................................................49
2013 Provisional Scout Application..................................................................................................50
Section IX - Forms...........................................................................................................................51
Campsite Inspection Form................................................................................................................51
Service & Spirit Award.....................................................................................................................52
2013 Unit Roster and Registration...............................................................................................53-54
2013 Merit Badge Registration Form..........................................................................................55-56
Long Term Campership Application.................................................................................................57
Camp Volunteer Leader Application.................................................................................................58
2013 Summer Camp Staff Application........................................................................................59-61
2013 Camp La-No-Che News...........................................................................................................61
Annual Health and Medical Record.............................................................................................62-69
SCUBA Program Forms..............................................................................................................70-75
Unit Swim Classification .................................................................................................................76
Location of Camp.............................................................................................................................77
Location of Camp (wihtin Central Florida)......................................................................................78
Map and Directions to Camp............................................................................................................79
Additional Map and Directions to Camp..........................................................................................80
Map of Camp....................................................................................................................................81
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Section I - Introduction and Summary
Camp La-No-Che Highlights
Camp La-No-Che is proud of our program excellence and was a
2012 Nationally Accredited Boy Scout Resident Camp
Reservations
Please email your reservation request to [email protected] or call the camp office at (352)669-8558.
Please provide which week you request, which campsite you want, and the estimated number of Scouts/youth
and adults. We will be happy to assist with your reservations.
Merit Badge Class Registration
Once your reservation is set, if this is your Units first summer camp visit to Camp La-No-Che please call
the camp office at 352-669-8558 or e-mail Pam: [email protected] so that we can provide your unit
representative with a user name and password for merit badge registration and payment system. If you are a
returning troop you may use your username and password from the previous visit. If you cannot remember it
please contact camp to have it reissued to you. Starting on March 1, 2013, you will be able to manage your
merit badges online. However, if you do not wish to use the online merit badge registration, you may use
the schedule request provided in the leader’s guide. The online merit badge registration and payment system
instructions will be provided to the unit representative who will handle the process.
Facilities
Camp La-No-Che at the Leonard and Marjorie Williams Family Scout Reservation has an outstanding facility
to provide an enjoyable summer camp experience for Scouts, Venturers, and adult leaders. Here is a short list
of facility highlights:
• The W. T. Bland Dining Hall – Air-conditioned with a 600 person capacity, outstanding food service
with salad bars, cereal bars and beverage bars (with Pepsi Cola fountain service).
• Excellent aquatics facilities located on 2,352 acre Lake Norris in addition to a lighted swimming pool.
• Lighted sports area (basketball court, volleyball, and boulder wall).
• Expanded shooting sports area with lights (36 position rifle range, 5 stand shotgun range, black
powder/handgun range and 24 position sheltered archery range).
• Adventure Camp with ATV course, Alpine Tower, Climbing Tower, and C.O.P.E. Course
• New Bike Barn, Chapel and high tech Council Ring
• Air-conditioned Florida Hospital Health Lodge and Jack Jennings Trading Post.
• Campsites with activity shelters (electricity and fans); adult leader rooms; and latrines with private
toilets, hot water showers and sinks.
Communications
• E-Mail - Pam (merit badge schedules): [email protected]
- Kathy (payments and paperwork): [email protected]
- Chris Crowley (2013 Summer Camp Director): [email protected]
- Matt Ragan (Director of Support Services): [email protected]
- General delivery: [email protected]
• Website - http://www.camplanoche.com
• Phone - 352-669-8558 Fax - 352-669-7636
• Mail - Camp La-No-Che; P.O. Box 323; Paisley, Florida 32767
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Summer Camp Help
We have openings for summer camp positions. If you have good Scouts who are at least 15 years old, or adults,
please encourage them to apply. Also, we have a Counselor-in-Training program for Scouts who are 14 years
old. Feel free to e-mail, call or download an application online at www.camplanoche.com. Applications are
accepted August 1, 2012 - January 31, 2013.
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Camp La-No-Che
The Leonard and Marjorie Williams Family Scout Reservation
Summer Camp 2013
The Leonard and Marjorie Williams Family Scout Reservation has earned a reputation over the past sixty three
years as the premier Scout camp in Florida and the Southeast. On the shores of beautiful Lake Norris, nestled
on the south edge of the Ocala National Forest, Camp La-No-Che has exciting program features, great facilities,
and the best trained staff anywhere. A week at Camp La-No-Che is the perfect opportunity for a Scout to enjoy
camping, learn self-reliance, and acquire Scouting skills. Camp La-No-Che is an increasingly popular choice
among troops from other councils and even other countries, and why many Scouts choose to return for a second,
third, or even fourth week each summer.
Scout Fees for Summer Camp
For reservation information, contact
Central Florida Council
Camp La-No-Che
P.O. Box 323
Paisley, FL 32767
352-669-8558 Phone
352-669-7636 Fax
[email protected]
http://www.camplanoche.com
On-Time means pre-registered and paid on time. Late
means complete payment not received two weeks prior
to your week of summer camp. *FOS means the Scout
is a member of a Central Florida Council unit which
holds an FOS presentation by April 15, 2013.
Traditional Camp
Scouts On-Time
Scouts On-Time *FOS
Scouts Late
Provisional Scouts On-Time
Provisional Scouts On-Time *FOS
Provisional Scouts Late
Troop Photograph - 5"x7"
Troop Photograph - 8"x10"
Water Skiing / Wake Boarding
Motor Boating
Additional Leader Fee
Weeks of Summer Camp
Week 1
Week 2
Week 3
Week 4
Week 5
Week 6
Week 7
N.Y.L.T.
June 9-15
June 16-22
June 23-29
June 30-July 6
July 7-13
July 14-20
July 21-27
July 28 - Aug 3
Policy Statement
The programs and facilities of the Central Florida
Council, Boy Scouts of America, are available to everyone
who meets Scouting membership requirements and
qualifications. No person shall, on the grounds of race,
color, or national origin, be excluded from participation in,
be denied the benefits of, or be subject to discrimination
in the use of the same. The Central Florida Council does
not provide Camper's Accident Insurance.
Physical Exams
All campers, both youth and adult, must have an official
B.S.A. Annual Health and Medical Record. This is the only
form that will be accepted by camp and it must have been
completed within 12 calendar months before arrival to camp. A
copy of the official B.S.A. Annual Health and Medical Record
can be found in Section IX of this guide.
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$250
$240
$275
$275
$265
$300
Add $5
Add $8
Add $45
Add $25
$110
Adventure Camp
Project C.O.P.E.
Alpine Adventure
La-No-Che Power Sports - A.T.V
La-No-Che Power Sports - P.W.C
Sea World Aquatics Adventure
Poseidon's Odyssey
SCUBA Certification
SCUBA Advanced
Bronze Attraction Trek
Silver Attraction Trek
Gold Attraction Trek
Premium Attraction Trek
Add $45
Add $35
Add $25
Add $45
$310
$310
$390
$390
$330
$350
$400
$420
Camp Programs Offered
Aquatics
Advanced Sailing
Aquatics
Supervision
Boardsailing
Canoeing
Kayaking
Lifesaving
Motorboating
Personal Watercraft
(P.W.C.)
Adventure Camp
Native American
American Culture Tracking
Wilderness
American Heritage Survival
Archaeology
Woodsman 1 & 2
Indian Lore
Ecology
Animal Science
Astronomy
Bird Study
Dog Care
Forestry
Insect Study
Fish and Wildlife Space
Management
Exploration
Scuba
Nature
Oceanography
Soil and Water
Fish & Wildlife
Conservation
Management
Small-Boat Sailing Veterinary Medicine Trail Boss
Snorkeling
Pulp & Paper
Mamal Study
Swimming
Environmental Science
Instructional
Handicraft
Healthcraft
Swim
Wakeboarding
Art / Basketry
Athletics / Sports
Water Skiing
Scoutcraft
Cinematography Crime Prevention
Camping
Collections
Disability
Awareness
Cooking
Fingerprinting
Fishing
Leatherwork
Emergency Prep.
Geocaching
Music and Bugling Fire Safety
Orienteering
Pottery/Sculpture First Aid
Pioneering
Public Speaking Personal Fitness
Shooting Sports Theatre
Safety
Advanced Rifle
Woodcarving
Traffic Safety
Skills
Advanced Shotgun
Archery
Auto Mechanics Electricity
Rifle Shooting
Electronics
Home Repairs
Shotgun Shooting Painting
Photography
Adventure Camp Plumbing
Radio
Climbing
Robotics
Chess
Cycling
Inventing
Welding
Leadership Academy
Search & Rescue
Trailblazers
Communications
New Scout Program
Citizenship in the Nation
Citizenship in the
Family Life
World
Personal Mangement
Rowing
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Attraction Treks
• Bronze Trek
• Silver Trek
• Gold Trek
• Premium Trek
E-Treme Power Sports (A.T.V)
Project C.O.P.E. (13 +)
Alpine Adventure (14+)
Sea World Aquatics Adventure
Poseidon's Odyssey
Traditional Camp Troop Activities and Trails
Alexander Springs Canoe Run Parents' Night
Juniper Springs Canoe Run
Climbing
Sailing (must have SB Sailing MB) Tomahawk Throw
Black Powder Shooting
Archery
Shotgun Shooting
Camp Games
Rifle Shooting
Swimming
Conservation/Service Projects
Ice Cream Social
Opening & Closing Campfires Cat Eye Trails
Paul Bunyan Woodsman
Sulfur Springs Trail
C.O.P.E. Challenges
Bean Shooting
Totin' Chip / Fireman Chit
Trail Biking
Rowing and Canoeing
Aquatic Trail
Pizza Social or Snack Bar
Big Stump Trail
Trapper Creek Nature Trail
Atalatal
Custom Troop Activities
OA Crackerbarrel
Pow-Wow and Native American Education
Camperships
The Central Florida Council has limited camperships
available for Central Florida Council Scouts who need
assistance in paying their camp fees. Scholarship funds
are provided by private donors and are limited to those
who are truly in need. We encourage you to complete
an application as early as possible. It is our desire that
no Scout be denied the opportunity to attend camp due
to financial circumstances.
Provisional
If you are unable to attend camp with your troop
or if you just want to come to camp for another week,
a provisional troop is provided. Adult leadership is
provided for Scouts. Provisional campers have the same
opportunity to enjoy the program as other Scouts, and
even have the opportunity for some special activities.
Section II - Camp Schedules
Scoutmaster and Senior Patrol Leader Meeting Schedule
Time
6:00-7:00am
9:15am
Sunday
Monday
10 am-SM Safe
Swim and Safety
Afloat at
lakefront
10:00am
12:30pm
Afternoon
Tuesday
Wednesday
Thursday
Make own coffee in campsite
SM meeting in W.T. Bland Dining Hall
10:30 am
Adult
tomahawk
throw at
Native
American area
SPL meeting in Handicraft Pavilion
SM shotgun
competition at
shotgun range
4:30 pmSM/SPL
orientation
at Handicraft
Pavilion
SM dinner at
pool pavilion
6:00pm
Evening
Friday
7:45 pmTroop time
activity
signups at
Handicraft
Pavilion
7:15 pm-Meet
merit badge
counselors
in Handicraft
Pavilion for
blue card or
MB problems
Sunday Schedule
Time
Noon-3pm
4:30pm
5:45pm
6:15pm
7:15pm
7:45pm
8:45pm
10:00pm
10:30pm
Activity
Check-in and move into campsite
SM / SPL orientation meeting
Red wave flag ceremony, prayer, and dinner
Blue wave flag ceremony, prayer, and dinner
Religious service
Troop time activity sign-ups
Campfire program gathering
Troop PLC meeting in campsite
Camp taps / lights out
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Location
Campsites
Handicraft Pavilion
W.T. Bland Flag Pole
O.A. Museum Flag Pole
Chapel
Handicraft Pavilion
W.T. Bland Flag Pole
Campsites
Campsites
Monday - Friday Schedule
Time
Monday
6:00am
Tuesday
Wednesday Thursday
Friday
Location
Mile Swim
M-Pool, T-Th Lake
Mile Run
Healthcraft Pavilion
7:30am
Red Wave flag ceremony, prayer, and breakfast
W.T. Bland Flag Pole
8:00am
Blue Wave flag ceremony, prayer, and breakfast
O.A. Museum Flag Pole
9:00am
Merit badges, Trailblazers, and Adventure Camp
Camp
Noon
Red Wave prayer and lunch
W.T. Bland Flag Pole
12:25pm
Blue Wave prayer and lunch
O.A. Museum Flag Pole
12:30pm
Senior Patrol Leader meeting
Handicraft Pavilion
1:30pm
Merit badges, Trailblazers, and Adventure Camp
Camp
3:30pm
Troop time activities
Camp
4:30pm
Troop time activities
Camp
5:45pm
Red Wave flag ceremony, prayer, and dinner
W.T. Bland Flag Pole
6:15pm
Blue Wave flag ceremony, prayer, and dinner
O.A. Museum Flag Pole
7:30pm
Campwide games/troop time
Movies in W.T. Bland Dining Hall
8:00pm
Story Telling Jam Session
10:30pm
OA
cracker
barrel
8:30pm
Meet at
W.T.Bland
flag pole
for
Pow-Wow
in Council
7:15pm SM meeting
with MB counselors
at Handicraft Pavilion
8:30pm Meet at W.T.
Bland flag pole for
campfire
Camp Taps
Campsites
Saturday Schedule
Time
Wave Groups
Activity
Wave Color Campsites (subject to change)
7:00amBreakfast delivered to your campsite
7:30am
7:30am
Camp
Send a runner to the Gateway to check out
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Red
1,2,3,10,11,12,13,14,15,16,19,20
Blue
4,5,6,7,8,9,17,18, 21,22,23, 24, 25
Section III - Program Schedules
The merit badge programs are for all Scouts who are working toward rank advancement or specific skills and
interests. All Scouts need merit badge books for each merit badge class. All merit badge skills are offered in daily
sessions. However, extra time will be needed to complete some merit badges. Other merit badges will not require
a full week, and a second merit badge may be earned. The program areas are Adventure Camp, Aquatics, Ecology,
Handicraft, Healthcraft, Leadership Academy, Native American, Scoutcraft, Shooting Sports, Skills, and Special
programs. There are also activities other than merit badges, such as Aquatic Supervison, the Trailblazer program,
and older Scout programs. Class schedules, size limits, and preparation requirements are listed by program area.
Scoutmaster approval is required for a Scout to take merit badges.
We encourage new Scouts with less than six months in Scouting to attend one of the Trailblazer programs,
each of which consists of a two-hour block. During the other three merit badge periods, the new Scout can work on
Swimming, Rowing, First Aid, Handicraft, Scoutcraft, Native American and Ecology merit badges. Young Scouts not
participating in Trailblazers may also take numerous aquatic merit badges if they have the Swimming merit badge,
and many other badges based on the Scout’s interests.
Please refer to the following pages to plan your Scouts’ merit badge schedules by program area. Please register
online or complete the summer camp merit badge pre-registration form and send it to Camp La-No-Che. We suggest
the merit badge pre-registration be completed as early as possible for the best merit badge choices. Many units will
start sending in pre-registrations around January. Please have your pre-registration completed before May 1st. If you
have any problems or changes, please contact the camp office.
Merit Badge Records
We want your stay at The Leonard and Marjorie Williams Family Scout Reservation to be fun, relaxing and hasslefree, and we want dealing with the paperwork at home to be hassle-free, as well. We will continue to limit the size of
merit badge classes to ensure proper instruction. The camp will start accepting pre-registration for merit badges and
the special skill courses for this year's summer camp on March 1st. Courses will be filled on a first-come, first-served
basis. This will help the leader know his Scouts’ schedules and give the camp staff an idea of class loads.
The unit leader will receive a merit badge report on Friday night. The report will show which requirements have
been completed for each badge for each Scout. Each department director is a registered merit badge counselor for the
merit badges in his or her department. A troop may bring blue cards to the area directors for a signature Friday night
at 7:15 pm at the Handicraft Pavilion.
Merit Badge Not on Schedule
If a Scout is interested in a merit badge which is not on the schedule, please contact the Camp Program Office either
prior to camp or upon arrival on Sunday to discuss the possibility of making special arrangements for the badge.
Notes About Schedules
In the schedules on the following pages, the shaded areas represent the times when the classes are available.
The numbers in the shaded areas represent the capacities of the classes. An asterisk (“*”) next to the program name
indicates that the program is a merit badge class. In addition to the items listed under Preparation Needed Prior to
Camp, Scouts should read the merit badge books and bring the books to class for all merit badges.
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Adventure Camp
Older Scout programs are provided in the program areas. These adventures will be listed in the Adventure Camp
section of this guidebook. The most updated information is available online at http://www.camplanoche.com.
Troop Time Activities
All of the program areas offer troop time activities from 3:30 pm until 5:20 pm and in the evenings. Troop Time
activities are listed by program area, and more information is provided online at http://www.camplanoche.com. You
will register your troop on Sunday at 7:45 pm in the Handicraft Pavilion for troop time activities.
Payment of Fees for Classes
Program Area
Aquatics
Handicraft
Shooting Sports
Skills
Adventure Camp
Troop Times
Native American
Location to Pay Fees
Camp final payment to office
Trading Post
Camp final payment to office, except goggles, ear plugs, and arrow kit, which the Scouts will
purchase in the Trading Post
Trading post. Estimated costs represent TYPICAL amount spent by a Scout to buy class supplies
Camp final payment to office
Camp final payment to office
Primitive Cooking pays in class; Bean Shooter pays with camp final payment to office
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2013 Camp La-No-Che Merit Badge Schedule (sorted by Program Area)
Program(* indicates merit badge) Program Area
X-Treme Powersports - A.T.V.
Adventure Camp
Climbing* (11 or older)
Adventure Camp
Cycling* (11 or older)
Adventure Camp
Alpine Adventure (14 or older)
Adventure Camp
C.O.P.E. (13 or older)
Adventure Camp
Search and Rescue* (13 or older) Adventure Camp
Attraction Tours
Adventure Treks
Poseidon’s Odyssey
Adventure Treks
Sea World Aquatics Adventure
Adventure Treks
Advanced Sailing
Aquatics
Aquatics Supervision
Aquatics
Canoeing*
Aquatics
Instructional Swim
Aquatics
Kayaking
Aquatics
Lifesaving*
Aquatics
Motor boating*
Aquatics
Personal Watercraft
Aquatics
Rowing*
Aquatics
S.C.U.B.A.*
Aquatics
Small Boat Sailing*
Aquatics
Snorkeling
Aquatics
Swimming*
Aquatics
Watersports-Wakeboard*
Aquatics
Watersports-Waterskiing*
Aquatics
Windsurfing
Aquatics
Animal Science*
Ecology
Astronomy*
Ecology
Bird Study*
Ecology
Environmental Science*
Ecology
Environmental Science*
Ecology
Fish & Wildlife Management*
Ecology
Forestry* & Pulp & Paper*
Ecology
Insect Study*
Ecology
Mammal Study*
Ecology
Nature* & Weather*
Ecology
Oceanography*
Ecology
Reptile & Amphibian Study*
Ecology
Soil & Water Conservation*
Ecology
Space Exploration*
Ecology
Veterinary Medicine* & Dog Care* Ecology
Art* & Basketry*
Handicraft
Bugling* & Music*
Handicraft
Cinematography*
Handicraft
Collections*
Handicraft
Leatherwork* & Woodcarving*
Handicraft
Pottery* & Scultpture*
Handicraft
Public Speaking*
Handicraft
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9:00am 10:00am 11:00am 1:30pm 2:30pm
6
6 (12:30 - 3:30pm)
15
15
10
6-18 (1:00 - 3:30pm)
Min 6, Max 18, 8am-12pm
8
All Day Program (Will Leave Camp)
Min 6, Max 12 - All Day Program (Will Leave Camp)
Min 6, Max 12 - All Day Program (Will Leave Camp)
10
10
20
6
20
6
6
6
15
15
6
6
6
6
6
10
10
All Day
10
15
30
2
2
6
30
2
2
6
10
45
2
2
6
20
15
30
2
2
6
30
2
2
6
20
20
20
20
20
20
20
20
20
20
20
20
20
25
20
20
20
20
20
15
20
15
15
15
15
15
10
10
10
10
15
Theatre*
Athletics* & Sports*
Crime Prevention* & Traffic Safety*
Disabilities Awareness* & Public
Health*
Emergency Prepardness*
Fire Safety*
First Aid*
Medicine*
Personal Fitness*
Safety*
Citizenship in the Nation*
Citizenship in the World*
Communications*
Personal Management*
Handicraft
Healthcraft
Healthcraft
20
20
15
Healthcraft
Healthcraft
Healthcraft
Healthcraft
Healthcraft
Healthcraft
Healthcraft
Leadership Acad.
Leadership Acad.
Leadership Acad.
Leadership Acad.
Family Life* & Citizenship in Comm.* Leadership Acad.
American Culture*
Native American
American Heritage*
Native American
Archaeology*
Native American
Indian Lore*
Native American
Tracking
Native American
Wilderness Survival*
Native American
Woodsman 1
Native American
Woodsman 2
Native American
Camping*
Scoutcraft
Cooking*
Scoutcraft
Geocaching
Scoutcraft
Fishing*
Scoutcraft
Orienteering*
Scoutcraft
Pioneering*
Scoutcraft
Advanced Rifle
Shooting Sports
Advanced Shotgun
Shooting Sports
Archery*
Shooting Sports
Rifle Shooting*
Shooting Sports
Shotgun Shooting*
Shooting Sports
Auto Mechanics*
Skills
Chess*
Skills
Electricity*
Skills
Electronics*
Skills
Home Repairs*
Skills
Inventing*
Skills
Painting*
Skills
Photography*
Skills
Plumbing*
Skills
Radio*
Skills
Robotics*
Skills
Welding*
Skills
16
20
25
25
25
25
25
25
35
35
35
35
25
25
35
15
25
25
15
20
20
20
20
20
30
30
30
30
30
30
15
15
30
15
15
15
15
15
15
15
15
15
15
15
15
15
15
15
10
15
15
15
5
5
26
32
12
8
26
32
12
8
10
8
10
8
10
10
10
8
12
15
6
2013 Camp La-No-Che Merit Badge Schedule (sorted by Program Name)
Program(* indicates merit badge)Program Area
Advanced Rifle
Shooting Sports
Advanced Sailing
Aquatics
Advanced Shotgun
Shooting Sports
Alpine Adventure (14 or older)
Adventure Camp
American Culture*
Native American
American Heritage*
Native American
Animal Science*
Ecology
Aquatics Supervision
Aquatics
Archaeology*
Native American
Archery*
Shooting Sports
Art* & Basketry*
Handicraft
Astronomy*
Ecology
Athletics* & Sports*
Healthcraft
Attraction Tours
Adventure Treks
Auto Mechanics*
Skills
Bird Study*
Ecology
Bugling* & Music*
Handicraft
Camping*
Scoutcraft
Canoeing*
Aquatics
Cinematography*
Handicraft
Citizenship in the Nation*
Leadership Acad.
Citizenship in the World*
Leadership Acad.
Climbing* (11 or older)
Adventure Camp
Collections*
Handicraft
Communications*
Leadership Acad.
Cooking*
Scoutcraft
C.O.P.E. (13 or older)
Adventure Camp
Crime Prevention* & Traffic Safety* Healthcraft
Cycling* (11 or older)
Adventure Camp
Disabilities Awareness* & Public
Healthcraft
Health*
Electricity*
Skills
Electronics*
Skills
Emergency Prepardness*
Healthcraft
Environmental Science*
Ecology
Environmental Science*
Ecology
Family Life & Citizenship in the Comm. Leadership Acad.
Fire Safety*
Healthcraft
First Aid*
Healthcraft
Fish & Wildlife Management*
Ecology
Fishing*
Scoutcraft
Forestry* & Pulp and Paper*
Ecology
Geocaching
Scoutcraft
Home Repairs*
Skills
Indian Lore*
Native American
Insect Study*
Ecology
17
9:00am 10:00am 11:00am 1:30pm 2:30pm
5
10
5
Min 6, Max 18, 9am-12pm
30
30
20
10
30
24
24
20
20
20
20
20
20
8
All Day Program (Will Leave Camp)
8
20
15
15
15
15
15
15
20
20
20
15
15
15
15
15
15
15
15
Min 6, Max 18, 8am-12pm
15
15
15
10
20
8
10
25
25
25
25
20
25
20
20
15
15
35
35
15
15
35
20
35
35
20
10
8
30
30
20
Instructional Swim
Inventing*
Kayaking
Leatherwork* (& Woodcarving*)
Lifesaving*
Mammal Study*
Motor boating*
Nature* & Weather*
Oceanography*
Orienteering*
Painting*
Personal Fitness*
Personal Management*
Personal Watercraft
Photography*
Pioneering*
Plumbing*
Poseidon’s Odyssey
Pottery* & Scultpture*
Public Speaking*
Radio*
Reptile & Amphibian Study*
Rifle Shooting*
Robotics*
Rowing*
Safety*
S.C.U.B.A.*
Sea World Aquatics Adventure
Search and Rescue* (13 or older)
Shotgun Shooting*
Small Boat Sailing*
Snorkeling
Soil & Water Conservation*
Space Exploration*
Sports*
Swimming*
Theatre*
Tracking
Veterinary Medicine* & Dog Care*
Watersports-Wakeboard*
X-Treme Powersports - A.T.V.
Watersports-Waterskiing*
Welding*
Wilderness Survival*
Windsurfing
Woodsman 1
Woodsman 2
Aquatics
Skills
Aquatics
Handicraft
Aquatics
Ecology
Aquatics
Ecology
Ecology
Scoutcraft
Skills
Healthcraft
Leadership Acad.
Aquatics
Skills
Scoutcraft
Skills
Adventure Treks
Handicraft
Handicraft
Skills
Ecology
Shooting Sports
Skills
Aquatics
Healthcraft
Aquatics
Adventure Trek
Adventure Camp
Shooting Sports
Aquatics
Aquatics
Ecology
Ecology
Healthcraft
Aquatics
Handicraft
Native American
Ecology
Aquatics
Adventure Camp
Aquatics
Skills
Native American
Aquatics
Native American
Native American
18
6
6
6
6
6
15
15
15
15
15
15
20
6
6
20
20
15
15
10
20
20
15
6
6
20
20
15
6
10
15
15
15
8
All Day Program (Will Leave Camp)
10
10
10
10
15
12
20
32
32
15
10
10
15
15
30
All Day
All Day Program (Will Leave Camp)
8
12
12
10
10
15
20
25
20
30
45
30
30
20
30
20
2
2
6
6
2
6
2
2
2
6
6
2
2
6 (12:30 - 3:30pm)
2
2
15
6
15
6
30
15
Adventure Camp
(for Scouts 13 years old or older)
Program
9:00am - noon
1:30pm - 3:30pm
Comments
See Section V; Cost $45;
Minimum 6, maximum 18, 8am
C.O.P.E.
eat breakfast with C.O.P.E
to noon
team at 7:20am
See Section V; cost $35;
Minimum 6, maximum
Alpine Adventure
Must be at least 14 years
18; 1pm-3:30pm
old
X-Treme Powersports:
Max - 8, 3 spots for 14 or 15
Max - 8 (same # of spots Cost $25; Must be at least
A.T.V.
years old and 5 spots for 16+
as AM), 12:30-3:30pm 14 years old with state ID
Search & Rescue*
Max - 8
13 years old or older
Note: Scouts must have a current official B.S.A. Annual Health and Medical Record to participate.
Alpine Adventure - Alpine Tower at Adventure Camp
• One of our highlights in the Adventure Camp is the Alpine Tower, which stands 50’ tall and weighs over
18,000 lbs. With a Giant Swing by Choice attached to the Alpine Tower extending out 110’, it is sure to
intimidate and test even the bravest of Scouts. Scouts must be 14 years of age.
X-Treme Powersports A.T.V.
• We have team with the A.T.V. Safety Institute of California to provide our newest addition to the
Adventure Camp. The X-Treme Powersports A.T.V. program teaches Scouts the fundamentals of
proper control, stopping and turning while operating an A.T.V.
Search and Rescue*
• Scouts will learn the differences between search and rescue. Scouts will also learn the fundamentals of
SAR (Search and Rescue).
Adult Leaders
• C.O.P.E. & Alpine Tour - Thursday after adult leader meeting.
• Alpine Experience - Friday after adult leader meeting (if you participated in the Thursday tour).
Troop Time
• Troop C.O.P.E. Challenges
• COPE Night Prowler - An experience for Scouts 14 years of age or older which involves a night zip
line ride. This activity runs from 9:00pm - 11:30 pm on Tuesday. Cost $7.00 per person.
Cancellations due to weather cannot be rescheduled.
• Alpine Psycho Swing - Deep in the woods stands a 60 foot tower, with lights and music it transforms
into a night time experience for Scouts 14 years and older. Come experience Psycho, only offered on
Monday and Wednesday during summer camp. Cost is $7.00 per participant. Cancellations due to
weather cannot be rescheduled.
19
Adventure Camp
(for Scouts 11 years old or older)
Program
Climbing*
Cycling*
9:00am
10:00am
11:00am
1:30pm
15
2:30pm
15
10
Preparation Prior to Camp &
Comments
Cost $20
Cost $30 using camp bike or $5
using own bike
* BSA Merit Badge
Troop Time (3:30 pm to 5:20 pm and evening programs)
• Climbing - cost $8.00 per person
• Paisley Woods Trail Biking - cost $5.00 per rider, must have adult chaperone from unit
Program area: Climbing
Climbing Merit Badge
• No jean pants or shorts
• No loose shoes such as skate board shoes, sandals or boots
• No Scout shorts or green Scout socks
• If hair is past your ears, it may have to be tied back
Program area: Cycling
Cycling Merit Badge
• Recommended that Scouts bring a camel pack
• No jean pants or shorts, Scout shorts or socks, or other heavy
pants
• No trick bikes
• If Scout brings own bike, it must be in good working order
• Must have ability to ride long distances during the week
Adult Leader Program: Climbing Topping Out Training
• A 2 year certification course (cost $35)
• 16-17 year olds can be instructors-in-training
• 18 year olds and older can be instructors
20
Adventure Treks
(for Scouts 13 years old or older)
Program
Sea World Aquatics
Adventure
Poseidon's Odyssey
N.Y.L.T.
Attraction Tours
9:00am 10:00am 11:00am 1:30pm 2:30pm
Preparation Prior to Camp &
Comments
All day program (will leave camp)
See Section V; Cost $310
All day program (will leave camp)
See Section V; Cost $310
Offered July 28 - Aug. 3rd; See
Section V; Must be at least 14 years
old & First Class
See Section V; Cost varies depending
on options
All day program (will camp with N.Y.L.T. program)
All day program (will leave camp)
21
Aquatics
Program
Instructional Swim
Swimming*
Snorkeling
9:00
am
30
15
10:00 11:00 1:30
am
am
pm
6
30
45
30
15
2:30
Preparation Prior to Camp & Comments
pm
Other times may be available
30 Req. 2a and 2b, and bring clothes for req. 4
$8 rental fee for mask and fins, keep snorkel
Aquatics programs listed below may be taken only if Swimming Merit Badge has already been earned
Advanced Sailing
10
Aquatics Supervision
Canoeing*
Lifesaving*
Motorboating*
Rowing*
Kayaking
10
20
15
20
15
6
6
10
6
10
6
Personal Water Craft
6
6
S.C.U.B.A.*
Small-Boat Sailing*
Watersports-Wakeboard*
Watersports-Waterskiing*
Windsurfing
6
6
All Day Class
10
2
2
6
2
2
6
10
2
2
6
2
2
6
2
2
6
Small Boat Sailing MB required
Must be 16 years or older; Aquatics Supervision
Manual
Req. 2a and 2b; knee pads are helpful
Req. 13a and 13b, clothes for req. 7e
Req. 1b, $25 fuel and maintenance fee
Req. 2a and 2b
Must have Canoeing MB
Must be 15 years or older and have Florida Boater's
Education Card; $45 Fuel & Maintenance Fee
Complete required paperwork; need SCUBA quality fins, mask & snorkel; Cost $390; Minimum age
14; See Section IV for more information
Req. 1b
Req. 2a and 2b; $45 fuel and maintenance fee
Req. 2a and 2b; $45 fuel and maintenance fee
Must be able to pick up sail
* BSA Merit Badge
Please bring water shoes to all lakefront merit badges and activities.
Mile Swim - Mandatory registration meeting will be Sunday evening following the campfire at the pool pavilion.
Meet at 6:00 am - Monday at the pool and Tuesday-Thursday at the lakefront. Make-ups are held daily at 3:30
pm at the lakefront. Pre-registration required on Sunday at troop time sign-up by bringing list for your troop.
Leader Training - Safe Swim Defense / Safety Afloat Monday at 10:00 am
Aquatics Supervision, B.S.A.
• Training for BSA Swimming & Water Rescue provides BSA leaders with information and skills to prevent,
recognize, and respond to swimming emergencies during unit swimming activities. It expands the awareness
instruction provided by Safe Swim Defense training. Persons completing the training should be better able
to assess their preparation to supervise unit swimming events. The BSA recommends that at least one person
with this training is present to assist with supervision whenever a unit swims at a location that does not provide
lifeguards. This training is open to any registered adult leader, Scout, Venturer, or Explorer who is age 16 or
older. The course takes approximately eight hours and is valid for three years.
• BSA Paddle Craft Safety expands Safety Afloat training to include the skills, as well as the knowledge, needed
for a unit leader to confidently supervise canoeing or kayaking excursions on flat water. Persons completing the
training should be better able to access their preparation to supervise paddle craft activities. The training is open
to any registered adult leader, Scout, Venturer, or Explorer who is age 16 or older. The training takes roughly
eight hours and is valid for three years.
22
Older Scout Programs
• Scuba Certification - Scout must be 14 years old, and will be certified by P.A.D.I. at the completion
of camp. Cost is $390.00. See Section IV for more information.
• Advanced Scuba - Scout must be 14 years old and already certified by P.A.D.I. The Scout will
work on advancing his Scuba skills and will go on a day trek to scuba dive. Cost is $390.00. See Section
IV for more information.
Troop Time (3:30 pm to 5:20 pm and evening programs)
• Canoeing on Lake Norris
• Rowing / Kayaking
• Swimming
• Sailing (must have Small Boat Sailing merit badge) (only 3:30-5:20 pm)
23
Ecology
Class
Animal Science*
Astronomy*
Bird Study*
Environmental Science*
Environmental Science*
Fish and Wildlife
Management*
Forestry* and Pulp & Paper*
Insect Study*
Mammal Study*
Nature* and Weather*
Oceanography*
Reptile and
Amphibian Study*
Soil and Water Conservation*
Space Exploration*
Veterinary Medicine* and
Dog Care*
9:00 10:00 11:00 1:30 2:30
Preparation Prior to Camp & Comments
am
am
am
pm pm
20
20
Req. 5
20
Bring money to buy bird house
20
20
20
20
20
20
Req. 7
20
20
20
20
Nature req. 4a, 4d, 4e or 4f; Weather: none
Need money for clay
Req. 8
20
25
20
Need money for rocket kit
Vet. Med req 6; Dog Care req 4 & 8
* BSA Merit Badge
Troop Time (3:30 pm to 5:20 pm and evening programs)
• Trails - several trails are listed later in this guide, and information on new trails will be provided at the
Sunday evening SM/SPL meeting
• Pulp and Paper Merit Badge – Make sure to bring filled out blue card to this class.
• Conservation Projects: Projects and supplies provided by Ecology Department. Please see the Ecology
Director to sign up.
• Conservation Challenge Program: Scouts can earn the Florida Hunter Safety Certification. Class will be
held Wednesday at 6:30pm at the Ecology lodge. Requirements and more information provided in Section VI of this leaders guide. Please see the Ecology Director when you arrive on Sunday to register for
this program.
24
Handicraft
9:00 10:00 11:00 1:30 2:30 Preparation Prior to Camp & Comam
am
am
pm pm ments
Art* and Basketry*
20
20
20
20
Estimated cost $15
Cinematography*
20
Collections*
15 Bring photos of your collection(s)
Bring whittling knife and have Totin'
Leatherwork* and Woodcarving* 15
15
15
15
Chip; estimated cost $20
Music*,
Music req. 3 and 4; Bugling req. 6; need
15
Bugling*
music background
Pottery*and Sculpture*
10
10
10
10
Pottery req. 5 and 7; estimated cost $10
Public Speaking*
15
Theatre*
20
Class
*BSA Merit Badge
Older Scout Programs (for ages 13 and older)
• Theatre Merit Badge
• Cinematography Merit Badge
Troop Time (3:30 pm to 5:20 pm and evening programs)
• Fingerprinting Merit Badge (bring Blue Cards)
• Custom craft projects
• Additional project time
25
Healthcraft
Class
Athletics and Sports*
Disabilities Awareness*
Traffic Safety* &
Crime Prevention*
Emergency
Preparedness*
Fire Safety*
First Aid*
Personal Fitness*
Safety*
Medicine*
9:00
am
20
10:00 11:00
am
am
1:30
pm
20
15
25
25
25
2:30
Preparation Prior to Camp & Comments
pm
Athletics - Req. 3a-d & 5 / Sports - Req. 4 & 5
Req. 2
Traffic Req. 1a; Crime req. 7; notebook required;
bring a local newspaper to camp
25
25
Req. 8c (bring kit or SM note), and First Aid MB
25
35
Req. 11; Notebook required
Req. 2d
Req. 1a and 1b; 7 & 8. Will not complete. Finish
req. 9 at home after camp
Req. 2a-b, 3b, 4, and 6; notebook required
Req. 7a & 10
35
35
35
35
25
25
25
25
15
20
*BSA Merit Badge
26
Leadership Academy
Class
Boy Scout Trained Leader
Citizenship in the Nation*
Citizenship in the World*
Communications*
Personal Management*
Family Life* & Citizenship in
Community*
9:00 10:00 11:00 1:30 2:30 Preparation Prior to Camp &
am
am
am
pm pm Comments
All Day Program
20
Req. 2a-d & 8
20
Req. 7
20
Req. 4, 5, 7 & 8
20
Req. 1, 2 & 8
Family Life Req. 3, 4, 5, & 6B
20
Cit in Community Req. 2, 3, 4b & 7c
*BSA Merit Badge
Boy Scout Trained Leader (Adult Leader Program)
• This week long course will cover Instroduction to Scoutmaster Position Specific, Outdoor Leader
Skills (IOLS) and Troop Committee Position Specific Trainings. This course will have several evening
sessions so make sure to have enough adult leadership to supervise your unit in the evenings. Please
register in advance for this program
27
Native American
Class
American Culture*
American Heritage*
Archaeology*
Indian Lore*
Tracking
Wilderness Survival
Woodsman 1
Woodsman 2
*BSA Merit Badge
9:00 10:00 11:00 1:30 2:30
am
am
am
pm pm
30
30
30
30
30
30
15
15
30
15
Preparation Prior to Camp & Comments
Req. 2, 4 prepare to present to class
Req. 4
Req. 1
Req. 5
See notes below
See notes below
Adult Leaders
• Native American activities for adult leaders: Woodsman 1 and Woodsman 2
• Scout leader tomahawk throwing 10:30 am on Wednesday
Additional Native American Programs
• Pottery Class, Monday & Wednesday, 7:30 pm at Rotary Lodge, Cost $0.50
• Pow-Wow Thursday evening in the council ring
• Story Telling Night, Monday, 8:30 pm at Dance Arbor
• Jam Session Night, Tuesday, 8:30 pm at Dance Arbor
Older Scout Class (10:00 am to 11:50 am)
• Woodsman 1 & 2: 13 years old and up-advanced outdoor survival skills (Wilderness Survival merit badge
required), learning Native American survival skills and practices, primitive weapons history,
fire making, history of Seminoles, hide tanning, and flint napping
Troop Time Activities
• Tomahawk throwing • Spear throwing
• Blow gun darts
• Native Amercan pottery class - $0.50
• Open village activities
• Bean shooter war (eye protection provided) - Cost $1 per person
28
Scoutcraft
Class
Camping*
Cooking*
Fishing*
Orienteering*
Pioneering*
Geocaching
9:00 10:00 11:00 1:30 2:30
Preparation Prior to Camp & Comments
am
am
am
pm pm
15
15
15
15
15 Req. 4b, 5e, 7b, 8d, 9a-c
15
15
15
15 Req. 7d and 8; will eat some meals with class
15
15
Req. 9; may bring own gear
15
15
15 Req. 9 and 10
15
15
15 Req. 2a and learn required knots
10
Req. 9
*BSA Merit Badge
Troop Time (3:30 pm to 5:20 pm and evening programs)
• Troop time fishing
• Paul Bunyan Award
• Muddy Tug-of-War
• Orienteering courses
29
Shooting Sports
9:00 10:00 11:00
am
am
am
Class
Advanced Rifle
5
Advanced Shotgun
5
Archery*
26
Rifle Shooting*
32
Shotgun Shooting*
12
1:30
pm
2:30
Preparation Prior to Camp & Comments
pm
Must have Rifle Shooting MB; cost $30; need safety
glasses and ear plugs
Must have Shotgun MB for youth; Need safety glasses,
ear plugs, & hat; Costs $125; Meets Mon-Wed at
8:30am; Shoots 200 rounds; Available for youth & adult;
Trophy
Need to bring merit badge book; Ability to draw &
26
maintain 20# bow; Cost $6 plus the cost of arrow kit
Need to bring merit badge book; Cost $15; Need
32
safety glasses & ear plugs
Need to bring merit badge book; Must have Rifle
12
Shooting Merit Badge; Cost $50; Need safety
glasses & ear plugs
*BSA Merit Badge
Note: Each Scout is responsible to provide his own goggles, ear plugs and merit badge books. They are
available to purchase in the Trading Post while supplies last.
Adult Leaders
• Shotgun trap and skeet shoot on Friday after SM meeting
• SM/SPL archery competition (Tuesday,
7:15pm at the Archery Range)
• SM/SPL rifle competition (Wednesday, 7:45pm at the Rife Range)
Troop Time (3:30 pm to 5:20 pm and evening programs) - Must have adult supervision at all ranges
• Rifle shooting - cost $1.00 per person
• Shotgun shooting - cost $2.00 per person
• Archery - cost $1.00 per person
• Black Powder shooting - cost $2.00 per person
30
Skills
Scout leaders are needed to teach these introductions to technical merit badges and may want to bring
their own teaching aids. If interested in teaching a skills merit badge, please email Chris Crowley ([email protected]
camplanoche.com) or call him at 407-703-0242. A supply list will be available online at www.camplanoche.com.
Please be aware that some Scouts cannot complete these merit badges at camp, but they will work on requirements
throughout the week and complete portions of the badges.
Class
Auto Mechanics*
Chess*
Electricity*
Electronics*
Home Repairs*
Inventing*
Painting*
9:00 10:00
am
am
8
8
10
Photography*
10
Plumbing*
Radio*
Robotics*
Welding*
6
11:00 1:30 2:30
Preparation Prior to Camp & Comments
am
pm pm
Req. 5d and 6b; need old clothes
10
8
Req. 8; merit badge kit $20 and goggles $3
Goggles $3, project $10
8 Goggles $3, need gloves, may not complete
10
10
Goggles $3
Need digital camera with charger and memory
card; $5 fee to be collected in class
8
Goggles $3
12
Req. 7 and 8
15
$15 fee to be paid at Camp Office
*BSA Merit Badge
Notes: If we do not get a counselor for a skills class, we will have to cancel the class. Scouts will then report to the
camp office to pick another merit badge class.
31
Trailblazer Program
(For Scouts with less than six months as Boy Scouts)
Program
Trailblazers
9:00am - 10:50am
55 - see below
1:30pm - 3:20pm
55 - see below
Comments
2 hours daily, see below
The Trailblazer program will be held daily in two two-hour sessions (9:00 am until 10:50 am or 1:30 pm until
3:20 pm). Scouts who participate will become versed in the Boy Scout ideals and patrol methods. Boys with less
than six months as Boy Scouts are encouraged to participate in the Trailblazer program. Three hours are left open for
the youth to participate in merit badge sessions that interest them. This program will introduce them to basic skills
required for advancement to First Class. All areas covered will be signed off on a special Trailblazer form. It is the
responsibility of the Scout­master to test the Scout when he returns home and then sign him off when he has proven that
he knows the skill. Scouts who have been in the Scouting program for six months or more and need only certain items
for advance­ment (i.e. knots, compass work, basic first aid skills, etc.) may find that their needs can be accomplished
during troop activity time with the appropriate program area (e.g., Aquatics). Feel free to set up required instruction
with department directors at the beginning of the week. Scout leaders are needed who have some free time and
can volunteer helping to enhance program instruction. Please sign up Sunday at the SM/SPL meeting.
Trailblazer Schedule
Sunday
Monday
Check-in; swim check
Totin' Chip; introduction to hiking; introduction to camping; sanitation and hygiene
Square knot; bowline; clove hitch; timber hitch; taut-line hitch; two half hitches; square lashing;
Tuesday
shear lashing; diagonal lashing
Wednesday Introduction to basic first aid
Thursday
Firem'n Chit; fire safety
Friday
Review; fun day
Note: This program is designed for new Scouts who have been in Boy Scouts for less than six months.
Troop Time (3:30 pm to 5:20 pm and evening programs)
• Totin' Chip
• Firem'n Chit
• Flag Retirement Ceremony
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Section IV - Traditional Camp
Advanced Programs
(For Scouts age 13 or older except as noted)
Advanced Sailing
This course is designed to review concepts learned in small boat sailing merit badge, as well as introduce twosail sailing and racing concepts. Participants will sail JY-15s and catamarans.
Advanced Shooting Sports
This shooting sports program is an opportunity for older Scouts who have completed the shooting sports merit
badges. Scouts continue shooting as they learn advanced skills in rifle shooting and shotgun shooting.
Boardsailing, BSA
This is a one-hour course designed for the older scout who loves the water. It is recommended that the scout
have the small boat sailing merit badge or sailing experience before taking this course. Scouts must be able to lift the
sail out of the water.
Paul Bunyan Woodsman
Splitting rails, felling trees and mastering the skills originally learned for Totin’ Chip are all part of the Paul
Bunyan experience. The Scoutmaster and SPL should register for the program at the Sunday evening meeting since
a limited number of groups will be scheduled each week. The emblem may be purchased at the trading post.
Scuba Merit Badge
All Scuba programs at Camp La-No-Che are brought to you through a partnership with Underwater
Adventures.
Scuba Certification - The Scuba program is a full certification program providing the Scout and adult leader an
opportunity to experience a different sort of high adventure. Providing that the participant completes all the course
requirements, they will have a PADI Open Water certification and memories that will last them a lifetime. More advanced courses are available. Please see the instructor.
The course cost is $390.00. The participants are required to have their own set of mask, snorkel, fins, and booties
of Scuba quality. (Sets purchased at Wal-Mart or Sports Authority are not suitable for Scuba diving.) The Scuba staff
can assist in the selection of this equipment. The scuba participant will be required to have the State Park access fees
of $10.65 for each day of diving at weeks end. There will be two days in which the scuba participants will be diving at
local State Parks. At times the scuba participants want to eat off camp so please plan accordingly for these two days.
As per all high adventure programs, participants are to be 14 years of age. Scuba is open to adult leaders as well
as scouts. All participants are to complete a Scuba Medical Questionnaire and Statement of Understanding of Liability
(both of these forms can be found in Section IX –Forms of this leaders guide). This Medical is separate from the BSA
medical required for camp and is to be signed by the parent or legal guardian for participants under 18 years of age.
Scuba Advanced Diving - This camp is for more advanced Scuba Divers that are already certified and experienced. You will experience different dives during camp at some exciting Florida Dive locations. Please check the
website (www.camplanoche.com) for additional information and updates! The Scout will need access fees for the
two days of diving at parks to complete the course, a total cost of $22.
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Slide Seat / Kayaking
This is a one-hour course that reviews basic kayak handling and safety while on the water. It is intended for
older Scouts who have earned canoeing merit badge.
Venturing Crews and Exploring Posts
Camp La-No-Che has many Adventure Treks and programs that are specific to Venturing Crews and
Exploring Posts. Please visit www.camplanoche.com to download the 2013 Venturing Crew and Explorer Post
Summer Camp Leaders Guide.
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Section V - Adventure Camps
For the Adventure Camps programs, one or two Scouts from a unit may come as Provisional Scouts. If a unit sends
three or more Scouts to an adventure, the unit must provide an adult leader. Also, a unit may schedule one of these adventures just for their unit if they meet the minimum requirements. Each camp has a minimum age requirement stated
in the description. All the adventures are subject to changes due to circumstances beyond our control. If a change
should be necessary, we will notify you as soon as possible. Also, each adventure has a minimum of 6 Scouts and a
maximum of 14 Scouts. If an adventure does not meet the minimum number required, a Scout may transfer to another
adventure. Please note that an official BSA Annual Health and Medical Record must be completed and signed
within the past twelve months.
Project COPE
This program, whose acronym stands for Challenging Outdoor Personal Experience, is designed for older Scouts.
Participants must be at least 13 years old by 6/1/13. Project C.O.P.E is a program which utilizes many unique obstacles,
games, puzzles and challenges that emphasize and encourage working as a team, developing leadership, and problem
solving, as well as building self-esteem.
Participants need a water bottle and insect repellant and are encouraged to wear long pants and tennis shoes
on Thursday and Friday while on the High Course events. An extra fee of $45.00 is required. All participants will
receive a COPE patch.
Low Events
TP Shuffle
Swinging Log
Wild Woosey
Water Wheel
Artesian Beam
Tire Traverse
Tire on a Pole
The Wall
Spider Web
Criss Cross
All Aboard
Islands
Port Hole
Trolley
A-Frame Shuffle
Drop Zone
The Beam
Triangle Traverse
Nitro Crossing
Blind Haze
High Events
Giants Ladder
Flying Squirrel
Confidence Pole
Cargo Net
Slack Line Traverse
Grapevine
Zip Line
Cat Walk
Alpine Tower Adventure
Our newest addition to our Adventure Camp is the Alpine Tower II, which stands 50’ tall and weighs over 18,000
lbs. With a Giant Swing by Choice attached to the Alpine Tower II extending out 110’, it is sure to intimidate and test
even the bravest of Scouts. An extra fee of $35.00 is required.
The Tower is designed for universal programming for individuals of all abilities, including participants with
disabilities. Alpine Tower II provides 30 different activities for Scouts to experience, with a wide variety of challenges.
Some challenges require the entire group for success. Scouts must me 14 years of age, with a current BSA physical.
Poseidon's Odyssey
Day
Monday
Tuesday
Wednesday
Thursday
Friday
Activities
Tubing and swimming on the Ichetucknee River
Canoeing the Silver River
Deep sea fishing
Windsurfing / basics of sailing
Waterskiing/wakeboarding/tubing; sailing regatta
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Sea World Aquatics Adventure
Experience a variety of aquatics activities plus venture to Sea World for a two day experience that includes spending
the night in close proximaty of Sea World sea life..
Day
Activities
Monday
Aquatics activities
Tuesday
Travel to Sea World for aquatic experience with overnight stay
Wednesday
Sea World for the day and then travel back to camp
Thursday
Travel to springs (emphasis on manatees and fresh water life)
Friday
Travel to Canaveral National Sea Shore (emphasis on Sea turtles and salt water life)
Additional Gear for Sea World Aquatics Adventure & Poseidon's Odyssey
Lightweight long-sleeved shirt
Water bottles or Hydration Pack
Sleeping bag (light weight)
Tennis shoes and sandals
Snorkeling gear
Fishing pole & supplies
Insect repellant
Lightweight long pants
Rain gear
Sunglasses
First aid kit
Underwear
Swim suits
Sunscreen
Mess kit, utensils
T-shirts
Shorts
Cup
Hat
Stove
Venturing / JROTC Ranger Camp
This camp is for Venturing and JROTC youth and involves working on requirements for the Ranger award.
The Venturing group will participate in fitness activities of running, swimming and sports. Also, they will have
opportunities to experience other adventures, such as canoeing, kayaking, climbing, caving, trail biking and much
more. More informaton is available in the 2013 Venturing Crew and Explorer Post Summer Camp Leaders Guide.
Attractions Tours
The Leonard and Marjorie Williams Family Scout Reservation is proud to provide exciting tour packages for
troops. You can tour Spaceport USA, U.S. Space Camp, Daytona U.S.A., Walt Disney World, Sea World, Universal
Studios Escape, and other Central Florida attractions and spend a day doing troop activities at The Leonard and Marjorie
Williams Family Scout Reservation.
At Kennedy Space Center, Spaceport USA, your unit will experience a simulated Apollo 11 moon launch countdown,
inspect a Saturn V rocket, see the enormous Vehicle Assembly Building, and view the IMAX film “The Dream is Alive.”
At Walt Disney World, Scouts will gain admission to one of the world’s favorite theme parks. Tour Tomorrowland,
Fantasyland, Adventureland, Frontierland, Cinderella’s Castle, and much more! Be one of the millions who visit
Mickey and his pals every year. Also, visit EPCOT, Disney-MGM, and Animal Kingdom.
At Sea World, you can witness the remarkable level of respect, understanding, and love between man and aquatic
wildlife as trainers play and perform with Sea World’s famous animal stars. You will also receive a special behindthe-scenes look at Sea World which is not available to the public.
Check out Universal Studios Escape, where you can see the fabulous “Jaws Encounter” and experience many,
many other great movie rides. Check out the Hard Rock Café and see memorabilia from your favorite stars, or visit
the new exciting Islands of Adventure. Also, we can arrange custom tours to other Central Florida attractions such as
Water Mania, Wet ‘n Wild, Silver Springs, Busch Gardens, and Daytona U.S.A.
As a final activity, you will be able to choose from a variety of troop activities for your unit, including hiking the trails of
La-No-Che, canoeing, rowing, swimming in the Olympic size pool, horseback riding (for a fee), archery, campfires, and more.
Troops will check in on Sunday between noon and 3:00 P.M. and check out on Saturday morning between 8:00
A.M. and 10:00 A.M. The tour package includes admission to all attractions, lodging, and meals at The Leonard and
Marjorie Williams Family Scout Reservation. Transportation costs are not included. Offered all seven weeks and
also throughout the year.
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Levels of treks - Premium, Gold, Silver, and Bronze
Premium - 4 attractions and 1 option - $420
Gold - 3 attractions and 1 option - $400
Silver - 2 attractions and 1 option - $350
Bronze - 1 attraction and 2 options - $330
Focus Programs for Attraction Treks
Fun & AdventureMovies & TV
Animals & ConservationSpace & Science
Attractions Choices
Attraction
Fun & Adventure
Movies & TV
Animals & Conservation Space & Science
Magic Kingdom
X
X
EPCOT
X
Disney - MGM
X
Animal Kingdom
X
X
Sea World
X
X
Busch Gardens
X
X
Universal Studios
X
X
Islands of Adventure
X
X
Kennedy Space Center
X
X
X
X
Option Choices
Disney Quest - Interactive Reality Games
Blizzard Beach - Water Park
Typhoon Lagoon - Water Park
Wet & Wild - Water Park
Wonder Works - Science & Adventure Reality
Additional Services
Please inquire at registration for more information
Transportation - Additional cost depending on group size and mode of transportation choice
Attraction MB Program - Most attractions will offer a merit badge class at additional cost
Attraction Dinner Vouchers - Offers groups discount dinner meals
Custom Tours
If you and your troop would like something special, such as two days of Attraction Tours and three days of
traditional camp, call our camping office and one of our Tour Consultants will help you design your own special camp
program. Offered all eight weeks.
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SectionVI - Trails, Activities, and Awards
Conservation Challenge Program
The Conservation Challenge Program is offered every Wednesday at 6:30pm at the Ecology Lodge. This program
gives the Scouts a chance to earn the Florida Hunter Safety Certificate. The requirements for this program are: To have
or currently be earning Archery, Rifle, Shotgun, and Fish & Wildlife Management Merit Badges; to participate in the
two hour hunter safety session on Wednesday afternoon; and to pass the exam at the end of the hunter safety session.
There is no cost to participate in this program. Upon completion of all of the required merit badges and the hunter safety
exam, you will receive the Florida Hunter Safety certificate and a special patch. If you wish to participate in this program,
please register with the Ecology Director when you arrive on Sunday.
Hiker of La-No-Che Trails
Hiking the trails of Camp La-No-Che at The Leonard and Marjorie Williams Family Scout Reservation can be a
rewarding experience for Scouts and Scouters alike. Information and helpful hints are provided to make this experience
even more fun. The Ecology department maintains and oversees the trail system throughout camp. Before starting any
hike, please notify the staff at the Ecology Lodge for directions, hints on changes and wildlife, and to sign the log book.
Report back to Ecology Lodge upon completion of each hike. Commissioner points are also awarded to the troops
participating and completing the Hiker of La-No-Che Trails award. To become a Hiker of La-No-Che and earn a special
patch, one must hike three trails, one of which must be hiked at night. The patch may be purchased at the trading post.
Big Stump Trail
This trail is a tradition at La-No-Che. Expect a muddy two hour walk through the Blackwater Swamp to view an
old first growth cypress stump and many natural areas of interest. To take this hike, report to the Ecology Lodge with
two leaders and ample time to complete the hike before dark. Weekly changes in times may be invoked as water levels,
staff schedules and weather require. Wear old clothes and closed-toe shoes, preferably all items to throw away after the
hike. Nobody comes back in clean clothes and the mud usually won’t wash out completely. Those who make it to Big
Stump and back fulfill the requirements for a special patch available for purchase from the trading post.
Cateye Trails
The Cateye Red Trail is marked with red reflectors which the Scouts follow. The route uses existing roads and
trails through the east side of camp to provide a challenge for everyone. Remember to bring your flashlights, look up
and keep a sharp eye out for the red cateyes.
The Cateye Blue Trail is marked with blue reflectors which Scouts will follow with the aid of their flashlights.
This trail was blazed by the ecology staff and is about an hour long. Remember your flashlights and keep an eye out
for the blue cateyes.
Sulfur Springs Trail
This spring is one of the natural wonders of La-No-Che which is being preserved and protected. Because of this
protection, you can experience this wonderful ecosystem which unfolds before you. Please do not damage plants and
trees along the way, but take lots of pictures. Also, remember that the Sulfer Spring is not a swimming hole.
Trapper Creek Nature Trail
This is an adventure in wetland forests and creeks that sometimes flow under two bridges. The wood ticks and
mosquitos may be a problem, so bring your repellent and spray your ankles. Hikers may see close to half of Camp LaNo-Che’s plant species on this trail along with many different types of animals. This trail will focus on interpretation,
making it an ideal resource for Nature and Forestry merit badges and Trailblazer requirements.
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Mile Run
In order to earn the Mile Run award, a Scout or leader must meet Monday morning at 6:00 at the Coggins Pavilion. The
award is a progressive award, so attendance every morning is required. The patch may be purchased at the trading post.
Mile Swim, BSA
Scouts and leaders participating in the mile swim must meet Sunday evening after the campfire at the pool
pavilion for registration and pre-swim meeting. Swims occur Monday – Thursday at 6:00am. Monday morning, the
group will meet at the pool. Tuesday through Thursday, the group will meet at the Phillip Starr Waterfront. The award
is a progressive award, so attendance every morning is required. Make-up swim and instruction is available Monday
– Thursday at 3:30pm at the Phillip Starr Waterfront. The national emblem may be purchased at the trading post.
Order of the Arrow
There will again be an OA Night during camp on Wednesdays. Scouts and Scouters are encouraged to bring
their sashes. Tipisa Lodge will host a crackerbarrel each Wednesday evening featuring free food, free drinks, and
fellowship for all Arrowmen.
Conservation Projects
If your troop is interested in doing a conservation project at camp, contact the Ecology staff for assistance. If
your troop wants to plan a conservation project prior to coming to camp and would like to bring items to accomplish
this task, please contact the camp at least one week before arriving.
Service Projects
If your unit is interested in doing a service project at camp, contact your camp commissioner for assistance. If
your unit wants to plan a service project prior to coming to camp and would like to bring items to accomplish this
task, please contact the camp at least one week before arriving. This will help the camp ranger determine what is
needed to help in accomplishing this task.
Troop Snack Social
Troop snack social is available for various snacks, including ice cream cones, nachos, popcorn, and soda. Each
Scout may choose his snacks from the serving line and pay at that time.
Troop Ice Cream Social
This great activity is fun for everyone. Please sign up for this event at the Troop Time Activity signup Sunday evening.
The ice cream social is held at the W. T. Bland Dining Hall Monday-Wednesday nights from 8:00pm until 9:30 pm.
Troop Pizza Social
Pizza is a great crackerbarrel item for an evening snack. Prices vary, so please make arrangements at the Troop
Time Activity Sunday evening. You may enjoy the pizza at the W. T. Bland Dining Hall Monday-Wednesday nights
from 8:00pm until 9:30 pm.
Troop Shoot
Troop shoots in Archery, Shotgun Shooting, Black Powder Shooting and Rifle Shooting are available during troop
activity time. Rifle shooting costs $1.00 per person, shotgun shooting costs $2.00 per person, black powder shooting costs
$2.50 per person, and archery costs $1.00 per person. The ranges can handle a limited number of participants at a time, so
make reservations with the Shooting Sports Director on Sunday evening at the Troop Time Activity signup.
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Troop Rowing
A fun activity at Phillip Starr Waterfront for any unit. Arrangements are made through the Aquatics department.
Troop Sailing
Troop sailing is a terrific water sport. Everyone, however, must have the Small-Boat Sailing merit badge. Due
to the popularity of this activity, an appointment must be made with the Aquatics Director by Monday.
Troop Swim
Swimming is very popular as a troop activity in the afternoon and evening during troop time. Make arrangements
at the Troop Time Activity signup on Sunday evening.
Snorkeling, BSA
This daily one hour program is offered during merit badge program sessions. Daily attendance is required. The
emblem may be purchased at the trading post.
Totin’ Chip / Firem’n Chit
These great programs are available during troop activity time and also through the Trailblazer department. Contact
the Trailblazer Director for more information at the Troop Time Activity signup on Sunday night.
Campwide Games
Prepare to experience challenges playing fast and furious games and skills as troops compete. On Monday evening through
Thursday evening, troops will compete. The program starts at 7:30 P.M. A list of events will be provided on Sunday afternoon
at the SM/SPL meeting. Awards will be given out Friday evening at the pre-campfire gathering. These games are optional and
troops may decide whether or not to accept the game challenges.
Troop Volleyball Tournament
The Camp La-No-Che Troop Volleyball Tournament is an opportunity to compete against other troops in a fun
game of volleyball. Sign up to compete in the tournament during the Sunday evening Troop Time Activity signup.
Troop Basketball Tournament
The Camp La-No-Che Troop Basketball Tournament is an opportunity to compete against other troops in a fun
game of basketball. Sign up to compete in the tournament during the Sunday evening Troop Time Activity signup.
Trail Bike Adventure
Camp La-No-Che is proud to own trail bikes to provide older Scouts opportunities for adventure in the Florida
outdoors on the Paisley Bike Trail. Scouts must be approved by their Scoutmaster to participate in this adventure.
The Paisley Bike Trail is a 22-mile circular trail through the Ocala National Forest. Register at the SM/SPL signup
Sunday evening. A small fee is associated with this adventure, and an adult leader must accompany the group.
Custom Troop Activities
If you have a special request for a custom troop activity, please let us know. If possible, please call ahead before
summer camp for special custom troop activities. However, you can set up some custom troop activities at the Sunday
night SM/SPL meeting.
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Commissioner’s Awards
The Commissioner’s Awards will evaluate campsites and Scout spirit/activity separately. Each troop will be
awarded a Commissioner’s Award for their troop flag, with the level of award based on the points earned during the
week. In addition, overall awards will be presented to the troops with the best campsite, the best Scout spirit, the best
gateway, and the best combined score overall. See Section X for the score sheets used for this award.
Summer Camp Patch
Each Scout and registered leader will receive a summer camp patch for completing a week at camp.
World Conservation Award
To complete the World Conservation Award, a Scout must earn the following merit badges: Environmental
Science, Citizenship in the World, and either Soil and Water Conservation or Fish and Wildlife Management.
Sports
Camp La-No-Che has a night sports program for Scouts and adult leaders on Monday, Tuesday, and Wednesday
nights at 7:00 on the sports field. Staff will compete against Scouts and adults interested in playing soccer. Camp LaNo-Che has lighted sports areas for basketball, volleyball, boulder wall, horseshoes, climbing, and shooting sports.
The sports schedule will be distributed at the Sunday SPL/SM meeting.
Gateway Competition
Build a gateway into your campsite. It must be creative and built by the youth, without digging any holes. Gateways will be judged on Thursday morning, and winners will be recognized at the Friday flag ceremony.
Patrol Flag Competition
Bring your patrol flags to camp. Turn them in at the Quartermaster Hut on Wednesday morning and pick them
up on Thursday after lunch. Winners will be recognized at the Friday flag ceremony.
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Section VII - Leader Information
Adult Leadership in Camp
Each troop must have one registered Scouter who is 21 years of age or older and one registered Scouter who is
at least 18 years of age as their camp leaders. Although not recommended, the camp leaders may rotate during the
week. In this case, the new leader must check in at the Camp Administration Building and the departing leader must
remain until his relief arrives. We only have campsite building quarters for two leaders from your unit. All other
leaders should expect platform tent quarters.
Scout Leadership in Camp
The troop’s Senior Patrol Leader should give leadership to the patrols. This is an excellent opportunity to develop
troop leadership, as the camp program will rely on the Senior Patrol Leader and Patrol Leaders for several camp-wide
activities. Camp information is distributed, and the SPL can ask questions about Commissioner’s Award points, camp
improvements, and equipment needs, and discuss problems his troop is experiencing. The SPLs meet daily at 12:30
pm. at the Handicraft Pavilion.
Camperships
The Central Florida Council has limited camperships available for Central Florida Council Scouts who need
assistance earning their fee to attend Camp La-No-Che summer camp. Application for this assistance may be made
by using the form in Section XVI. Please list the financial reasons which prompted you to submit an application.
This information will remain confidential. Funds are provided by private donors in the community and are limited
to those who are truly in need. We encourage you to make application before May 1. It is our desire that no Scout be
denied the opportunity to attend camp due to financial circumstances. If a Scout is provided a campership and does
not attend, the campership will not be refunded, but will be returned to the campership fund. If a Scout can afford to
pay for a week of camp, a second week of camp will not be considered for a campership.
Orientation Meeting
There will be a meeting for all SPLs and Scoutmasters on Sunday afternoon at 4:30 in the Handicraft Pavilion.
Troop Time Signup
There will be a troop time signup meeting Sunday evening at 7:45 at the Handicraft pavilion.
Out of Council Troops
In accordance with BSA national policy, troops from other councils must have a letter from their home council and
a tour permit granting them permission to attend The Leonard and Marjorie Williams Family Scout Reservation.
Scout Fees
Refer to Section I for Scout fees. Note that in 2013, the Scout fee is discounted $10 per Scout for all Central
Florida Council units that hold an FOS presentation between January 1 and April 15, 2013.
Leader Fees
Two adults leaders per troop may attend summer camp free. Troops which bring more than twenty Scouts are
allowed an additional leader free for every ten additional Scouts at camp. For example, a troop which brings thirty
Scouts to camp may bring three free leaders. Additional leaders will be charged $110 each. All fees are due as described
in the Fee Payment Schedule section. The camp fee covers meals, some program materials, camp staff, utilities, and
a summer camp patch.
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Additional Free Leader Program
The camp has a program designed to enhance the summer camp staff. Additional leaders may attend camp at no
cost by volunteering to assist in program areas for a total of fifteen hours. The schedules for the help will be arranged
through the program area directors. Jobs include lifeguarding or spotting at the pool or lake, teaching Trailblazer
skills, teaching “skills” merit badges, and assisting merit badge counselors. A special registration form may be found
in Section X. Please submit this form to the camp in order for us to review each adult leaders qualifications. Please
note that all adults must be approved to particpate in this program from camp.
Methods of Payment
All fees may be paid with cash, check, Visa, MasterCard, Discover, or American Express.
Fee Payment Schedule
Campsite Reservations: Campsite reservations may be made through 2/11/13 by calling the Council Camping
Office at 352-669-8558. To hold reservations beyond that date, a $100 campsite deposit must be paid. Reservations
made after 2/11/13 require a $100 deposit within seven calendar days. Troops may have to share a campsite with
another troop if they are unable to fill the entire campsite. Note that site deposits will be refunded to the unit by check
after their week is complete, after any damages to camp property found at check-out are deducted.
Individual Reservations: A deposit of $25 per Scout and $10 per paying adult is due before 3/1/13 with the
troop roster. If the deposit is not made by that time, the troop may lose its campsite if another troop requests that site.
Deposits must be accompanied by a roster from the forms section later in this guide. An additional $25 per Scout (for
a total of $50) and an additional $10 per paying adult (for a total of $20) is due before 5/1/13 with an updated roster.
If the second deposit is not made by that time, the troop again risks losing their choice of campsite.
Final Payment: The balance of all fees and a complete troop roster (see Section X) are due two weeks prior to
camp.
Late Fee: A $15 late fee per Scout will be assessed for those Scouts whose full fees are not paid by two weeks
prior to camp. There is no late fee for adults. However, you may add Scouts who are new Webelos crossovers or a
new Scout in your unit until up to one week before attending camp.
Refund Policy: All deposits are refundable until 5/1/13. No refunds will be made after that date except in case
of death in the family, relocation, illness (with physician verification), or summer school (with school verification).
Payment Review: Your invoice and payment record will be distributed at the Wednesday 9:15 am leader's
meeting at the W.T. Bland Dining Hall. Fees may be paid at the camp office at any time after that meeting and before
checkout on Saturday.
Proof of Insurance
Proof of unit accident insurance coverage must be shown upon arrival at The Leonard and Marjorie Williams
Family Scout Reservation in order to attend summer camp. The Central Florida Council does not provide Camper’s
Accident Insurance for out of council units.
Access Statement
The Leonard and Marjorie Williams Family Scout Reservation programs are available to persons with special
needs and disabilities. We will make every reasonable effort to meet the needs of all campers. Advance notice of special
requirements is greatly appreciated. For assistance or further information, please contact the Council Camping Office.
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Camp Meetings
Adult Leaders: There will be a leaders’ meeting Sunday afternoon from 4:30 to 5:30 in the Handicraft Pavilion.
At least one adult leader from each unit must attend. There will also be a dinner with the Council President and
Scout Executive Wednesday at 5:45 P.M. at the Pool Pavilion. Adult leaders are also encouraged to meet with the
Camp Director, Assistant Camp Director, or Program Director at 9:15 A.M. on Monday through Friday in the W. T.
Bland Dining Hall. A final meeting is held Friday evening to sign Merit Badge Blue Cards and answer any questions
concerning merit badge reports from 7:15 to 8:30 in the Handicraft Pavilion.
Senior Patrol Leaders: There will be an SPL meeting daily after lunch at 12:30 P.M. at the Handicraft Pavilion
. SPLs will also meet on Sunday from 4:30-5:30 pm with Scoutmasters in the Handicraft Pavilion.
COPE, Adventure Treks and Alpine Adventure: All participants should meet Sunday after the campfire show
on the W.T. Bland Dining Hall porch.
Mile Swim: All mile swimmers and lifeguard candidates should meet Sunday after the campfire show at the
Pool Pavilion.
Water Skiing and Wakeboarding Programs: All participants should meet Monday at 6:15 A.M. at the lake.
Photos
A representative from All-Rite Photo will be on hand Sunday during registration until 4:00 P.M. to take pictures
of your unit. Units should arrive in Field Uniform (“ Class A”) to have their photos taken, unless the troop would
prefer to wear a troop t-shirt. Each 5"x7" print costs $5.00 and each 8"x10" print costs $8.00. Payment for the photos
will be collected during your final payment. The troop will receive the photos at check-out on Saturday.
Mail
Camp La-No-Che at The Leonard and Marjorie Williams Family Scout Reservation has daily mail service. Camp
leaders should check for their troop’s mail daily on the front porch of the camp office. Mail should be addressed as
follows:
Scout’s or Leader’s Name
Troop Number
Camp La-No-Che
P.O. Box 323
Paisley, FL 32767
Vehicles
Due to some circumstances we understand that certain belongings need to be stored in a vehicle and thus will
allow one car per unit in each campsite (with the maximum of four total cars per campsite). On Sunday and Saturday,
vehicles will be allowed to transport gear to and from the campsite. Troops will be permitted to park their equipment
trailer in their campsite.
Email
You may send email to your Scout or leader. Please use unit number and Scout's first and last names in the
subject line and send to [email protected]
Telephone
The camp phone is for administrative and emergency use only! The phone number is 352-669-8558.
Water and Ice
Leaders are encouraged to stress the importance of drinking plenty of water. This helps to aviod heat exhaustion.
Water will be provided in each Program Area. Units are encouraged to bring a cooler and may get ice from the
Quartermaster Hut ice maker. No coolers are provided by camp.
44
Weather and Campwide Alarms
The weather in Central Florida is usually sunny and temperatures are usually in the mid 90s. During the summer,
we get a number of short, severe thunderstorms. These thunderstorms frequently produce dangerous lightning. Please
remind Scouts of the danger of lightning and discuss precautions to take during the storm. All outdoor programs are
canceled during lightning storms. Arrangements are made to make up work missed due to canceled classes.
Camp La-No-Che offers alert systems to make sure all Scouts and Scouters stay informed and maintain a safe
camping experience. The following are the Camp La-No-Che alerts:
• THOR Guard - a weather system that will notify our camp of incoming inclimate weather. The THOR
Guard will make a 15 second alarm sound. When this 15 second alarm sound goes off Camp
La-No-Che is under Lighting Alert Red and every Scout and Scouter must stay in a safe location and
adhere to Staff instruction.
• Camp Wide Emergency - this alarm will go off in the event of an emergency that requires the Camp to
assemle in assigned locations. This alarm will sound like a Siren and will continue to go off until all
Scouts and Scouters have checked in with thier assigned location.
• Camp La-No-Che Text Info - we utilize a text messaging system that will allow us to communicate with
Scouters throughout thier week of Summer Camp. Instructions on how to sign up for this very
important communication system will be covered during the Sunday 4:30pm Leader / SPL meeting.
Medical Services
Each participant, Scout or adult, must have a completed medical form. All Scouts and adults must complete the
official Annual BSA Health and Medical Record . These forms must accompany all Scouts and leaders to camp, including
all adults staying one or more nights. Please make copies of the appropriate forms for all boys and adults in your troop.
The forms are included in Section IX of this guidebook for your convenience. Parents’ and doctor’s signatures must
be on the health form. Health history must be current and the date of the physical must meet the requirements of the
appropriate form. Failure to comply with health form requirements will cause the person to be sent home. A fax machine
is available, so any forgotten forms must be faxed prior to the last transport adult leaving camp or the camper will be
sent home. The fax number is 352-669-7636.
In case of a medical emergency of any type, go directly to the Florida Hospital Health Lodge. The full emergency
procedures for the camp will be reviewed during your camp tour on Sunday.
A resident Health Officer is available at all times to deal with accidents and sickness. He or she is not a medical doctor
but is qualified to administer first aid and deal with emergencies and minor sickness. The Central Florida Council does
not provide sickness and accident insurance. Each troop must provide proof of insurance and claim sheet at check-in.
Valuables
The Leonard and Marjorie Williams Family Scout Reservation management and staff will not be responsible
for individual camper or troop valuables while in camp. Use these tips to avoid any losses:
1.Advise Scouts to bring as few valuables as possible and encourage Scouts to use locked trunks.
2. Before you arrive, organize a troop bank system with the unit leader as the banker. DO NOT carry large
amounts of money around camp.
3. The camp leader should bring a lock box with him.
4. Move your unit to activities as a group. Never leave one or more Scouts at the campsite alone.
5.Advise your Scouts not to walk through another unit’s campsite.
6. When using the pool or boats, lock all valuables in the campsite or in vehicles to ensure their safety.
7.A safe is provided in the Camp Administration Building for your convenience.
45
Trading Post
Camp La-No-Che is proud of the Jack Jennings Trading Post. One section of the trading post is a store that
features a complete stock of craft items, uniforms, Scouting t-shirts, souvenirs, Scouting materials and much more!
You can also purchase numerous Camp La-No-Che patches and t-shirts. Another section is the snack bar, which offers
an assortment of refreshments such as pizza, hot dogs, ice cream, popcorn, candy, cookies, snow cones and other new
surprises. Store hours will be posted on the Trading Post.
Uniform at Camp
There are no uniform requirements during the day; however, all campers must wear
closed-toe shoes at all times. The only exception is that flip flops, aqua socks, or sandals
may be worn in the campsite when going to the shower.
Evening meal
Field uniform ("Class A")
Closing flag ceremony Field uniform ("Class A")
At the pool
Swim suits only, no cut-offs
Troop photographs
Field uniform ("Class A")
Campfire programs
Field uniform ("Class A")
During the day
Family Participation Night
Family Participation Night will be on Thursday evening this year. You can come to camp between 4:00 P.M.
and 6:00 P.M. You can attend the evening flag ceremony and eat dinner with your son, then participate in the evening
campfire program. The cost for the meal will be $7.00. Tickets can be purchased on arrival at the Check-In pavilion
next to the main parking area. Cub Scouts and Girl Scouts in uniform eat free. Plan to attend the Native American
Pow-Wow at the council ring.
Supplies
Supplies including brooms, plungers, hoses, and coffee pots will be in your campsite upon arrival. Your guide will
inspect and inventory the supplies to ensure that everything is present. If you need anything else, visit the Quartermaster Hut.
Hours and additional information about the quartermaster will be provided at the SM/SPL meeting Sunday afternoon.
Safety Rules
• One fire is permitted per campsite in the fire ring. Do not use pine cones, pine needles, Spanish moss, kerosene,
or gasoline in the fire. While burning, the fire must be attended at all times. Before leaving the fire, water must
be used until the fire is completely out and the ashes are cool.
• No flames or fires of any kind are permitted in tents.
• Cooking must be done at least twenty feet away from tents and buildings. Propane and liquid fuels may only be
used under supervision of adults. No gasoline is to be used. Fuel is to be stored away from tents and buildings.
Since raccoons can lift lids and open simple latches, food should be stored in containers with secure lids.
• Stick, roll-on, or pump insect repellant and deodorant is preferred, and aerosol should be avoided if possible.
If aerosol of any kind must be used, it must be used outside of tents and under adult supervision.
• Closed shoes must be worn at all times. Open shoes,flip flops,or sandals may be used between campsite and latrine.
• Riding on the tailgate of a car or in the back of a pickup truck is prohibited.
• All vehicles must be parked in the main camp parking lot.
• Extension cords may be used only inside buildings.
• Camouflage is highly discouraged at Camp La-No-Che.
• Use of alcoholic beverages and controlled substances are not permitted. Any individual or group violating this
rule must leave the facility.
• No fireworks or privately owned firearms are permitted on council-owned property.
• In the event of a camp-wide emergency (i.e., fire, tornado, etc.), the siren will sound. Upon hearing the siren,
all personnel will assemble at their respective wave flag poles and wait for instructions.
• All bicycle riders must wear safety helmets.
46
Check-In Procedure
Check-in begins at noon on Sunday afternoon. No troops will be checked in before noon. If you are unable to
arrive between 12:00 P.M. and 3:00 P.M. on Sunday afternoon, please notify the camp office at least two weeks in
advance to make other arrangements. If you encounter a delay en-route to camp, please contact us as soon as possible.
The Camp Program Office number is 352-669-8558. Leaders and troops will be greeted by the administrative staff
upon arrival. Please refer to the schedules for important upcoming meetings and orientations.
Please have the following forms ready:
• Roster of all youth and adults
• Completed medical form for each youth and adult, properly signed
• Tour Permit (out of council only)
• Revisions to merit badge classes (if any)
• Copy of troop insurance claim form
You will then be assigned a staff guide to assist you in the following check-in process:
• Staff guide will escort troop through check-in process, including first taking your unit to your campsite
• Medical form and medication turn-in to health officer, troop photo (wear field uniform (“Class A”) to camp)
• Inventory and inspection of camp equipment
• If you are new to camp and want a general tour around La-No-Che, please ask your guide
• Change into swimsuit for swim check
• Return to your campsite to unpack and get ready for a fun-filled week
Camp Preparation Checklist for Camp Leaders
• Schedule camp promotion program. (September / October)
• Hold a parents’ night to review troop camp plans and to sign up Scouts. (November)
• Make reservation and troop deposit for campsite. (December / January)
• Collect fees or plan fund raising program. (Winter / Early Spring)
• Check payment plan, making sure fees are in on time. (Spring)
• Online Merit Badge Registration begins on March 1, 2013.
• Pass out BSA Annual Health and Medical Record (Can be found in Section IX of this Leaders Guide) to
be completed and returned (EVERYONE MUST have had a physical on this form in the12 months prior to
participating in Summer Camp). Check for parents’ and doctors’ signatures. (April / May)
• Make sure that all Scouts prepare for their own programs and advancement courses. Merit badge books must
be read. (April / May)
• Set up transportation. Make copies of map to The Leonard and Marjorie Williams Family Scout Reservation
and Camp La-No-Che News in Forms section. (April / May)
• Have unit roster, any extra fees, all adult and youth medical forms, and proof of unit accident and sickness
insurance ready. (Week before summer camp)
• Pack your own gear and relax. You are ready for camp. (Day before summer camp)
• Head for The Leonard and Marjorie Williams Family Scout Reservation. (First day of summer camp)
Boy Scouts of America Smoke-Free Policy
Boy Scouts of America policy is to provide a smoke-free environment for all Scouting participants. Therefore,
smoking is not allowed at La-No-Che in the presence of youth or in buildings. You may smoke only in the designated
adult break area behind the trading post. Thank you for your assistance!
47
Meal Service
The camp is divided into two groups, each of which will eat together every day. Your group will meet at your
designated flag pole for a flag ceremony and prayer, then walk together to the dining hall. You will enjoy your meal
in air-conditioned comfort. If there are any special dietary needs, please call us before you arrive at camp so we can
make necessary arrangements. We ask that each troop assign Scouts to clean up after eating (picking up trash, wiping
tables, and sweeping up their eating area). Thank you!
Adult Leader Programs
Fishing
Come on down to Cheney Waterfront during free time to do some fishing. Talk with the other leaders, catch some
fish, and bring back some great fish stories to tell your troop. The best time to fish is early in the morning. You may want
to bring your own pole and tackle. Register your large fish catch with the Scoutcraft staff, and you may win the top fish
award for the week.
Adventure Camp
Go on a tour of Adventure Camp and visit Project C.O.P.E., the Alpine Tower, and much more. You’ll be able
to see what your older Scouts have been raving about and try an event or two. Leaders will need long pants and
closed-toe shoes. This program starts Thursday after the 9:15am Adult Leader Meeting inside the dining hall. Any
adult leader that participates in the Thursday Adventure Camp Tour is eligible to return Friday after the 9:15am Adult
Leader Meeting for a chance to climb the Alpine Tower. (weather permitting).
Safe Swim Defense and Safety Afloat
Safe Swim Defense and Safety Afloat training is a minimum requirement for year-round aquatic troop activities.
Every adult leader is encouraged to be trained in Safe Swim Defense and Safety Afloat. Training cards are good for
two years.
48
Scoutmaster Dinner
Each troop’s Scoutmaster is invited to attend a dinner hosted by the Council President and Scout Executive. You’ll
be able to ask questions and give suggestions on camp and council activities. The dinner will be held Wednesday at
6:00 P.M. at the Pool Pavilion.
Scoutmaster Meeting
A Scoutmaster meeting will be held Monday through Friday at 9:15 A.M. in the W. T. Bland Dining Hall. This
meeting will provide a chance to gain information about camp as well as provide input about your troop’s summer
camp experience at Camp La-No-Che. The Camp Director, Assistant Camp Director, or Program Director will lead
these meetings. Report campsite problems at this meeting.
Skeet Shoot
Come down to the shotgun range and test your abilities while having fun. Whether you’re an expert or a novice,
come experience another of camp’s popular activities.
Night Owl Adventure
Join the Camp Director and his management staff roaming the camp every night at 10:00 P.M. until approximately
midnight. We walk around to provide security. However, you usually discover much more than Scouts lost from their campsites.
Nature (deer, foxes, raccoons, bears, snakes, opossums, and more) comes out after camp is asleep. Join the Night Owl Club by
experiencing two late nights and earn a special Night Owl Patch. Sign up at the SM/SPL meeting Sunday afternoon.
Climb on Safely
Adults can take this 45 minute to 1 1/2 hour class to cover basic climbing safety and rules.
Climbing Certification
Adults learn how to set up a tower and the correct ropes and knots. This is a week-long class with a two-year
certification to be able to assist and help the Climbing Director.
Woodsman 1
Be part of Camp La-No-Che's Native American Village! This Course covers advanced survival skills.
Woodsman 2
Participants must have completed Woodsman 1. Be part of Camp La-No-Che's Native American Village! This
Course covers Native American traditional cooking techniques and cuisines.
49
Section VIII - Provisional Camping
La-No-Che Provisional Troop
Camp La-No-Che provides a provisional troop with a Scoutmaster and volunteer assistants for all seven weeks of
camp. The Scoutmaster will be hired by the Central Florida Council and will not hold any other camp positions.
This provides an opportunity for boys to attend camp who are unable to attend camp with their troop, who wish to
attend more than one week of camp, or who are attending specialty camp without a troop.
Specialty weeks and the provisional troop are not intended to be alternatives to troop camping. Any troop sending
four or more boys to the provisional troop or a specialty week will be expected to provide an adult to assist with
leadership. Questions concerning this issue may be directed to the camp office. An application is provided on the
next page. The information below should be provided to parents of all Scouts attending with provisional.
Dear Provisional Parents:
We look forward to having your son spend a week with us at camp. As a provisional camper the following is a
list of what he should bring with him:
Enough clothes for a week at camp, including plenty of socks. We do a lot of walking and blisters are common.
Closed-toe shoes are to be worn at all times, and a spare pair of shoes is important.
• Field (“Class A”) uniform. A Scout should travel in field uniform, wear it to dinner each night, and have his
provisional troop photograph taken in it.
• Swim suit and towels
• Long pants and a long sleeved button up shirt for boys taking any of the aquatics merit badges.
• Toilet articles: soap, toothbrush, toothpaste, comb, etc.
• Raincoat or poncho
• Flashlight
• Insect repellent
• Pocket knife
• Compass
• Sleeping bag or sheet and blanket. We will sleep on cots. For his sleeping comfort, he should bring a mosquito net.
• Scout handbook, merit badge books, paper, and pens
• If taking the Big Stump hike, he should bring clothes and shoes that can be thrown away after this very muddy hike.
• Spending money (No large amounts of cash)
• Locked trunk to store everything (or at least valuables)
• $25 activity fee to participate in daily activities, payable to camp office prior to arrival
•
Please don’t send unnecessary items to camp that might get broken, lost, or stolen. Label everything he does
bring. If you would like to write to your son, please address mail as follows:
Scout’s name
Provo Troop
Camp La-No-Che
P.O. Box 323
Paisley, FL 32767
Thursday night is parents’ night. For a $7.00 charge you are welcome to have dinner with your son and see a
special program. Cub Scouts in uniform eat free. You may purchase dinner upon arrival at the check-in pavilion next
to the main parking area. Thanks for letting your son have the opportunity to attend camp.
50
2013 Provisional Scout Application
Thank you for inquiring about the provisional troop at Camp La-No-Che at the Leonard and Marjorie Williams
Family Scout Reservation. This is a special program for Scouts whose troop will not be attending camp, who cannot
attend with their troop, or who choose to attend more than one week. The cost of this program is $275.00, which
includes leadership, meals, camp staff, utilities, photo and a camp patch. Scouts whose units held a Friends of Scouting presentation during the 2012-2013 FOS Season qualify for a $10 discount. There may be additional costs for
materials in certain merit badge programs and different fees required for Adventure Camp. A $25.00 deposit is due
with this application, and the full balance is due two weeks prior to camp. Please fill out the information below and
have it signed by a parent or guardian and your Scoutmaster. Also, please complete the merit badge schedule request
for your Scout and mail it to the camp as early as possible. We look forward to having you for a great week at camp.
Please print
Name:
Troop:
Address:
District:
City, State, Zip:
Council:
Email:
Age:
Phone Number:
Rank:
Parent Name (printed):
Parent Signature:
Date Signed:
Scoutmaster Name (printed):
Scoutmaster Signature:
Date Signed:
Week in Provisional Troop
___ Week 1 - June 9-15
___Week 2 - June 16-22
___Week 3 - June 23-29
___ Week 4 - June 30-July 6
___Week 5 - July 7-13
___Week 6 - July 14-20
___ Week 7 - July 21-27
___ I would like to participate in Project C.O.P.E. Enclosed is an extra $45.00 for this program. I have attained
the rank of First Class and I will be at least 13 years of age as of 1/1/13, or I will have completed 7th grade by
camp. I also realize I must have a medical examination within the past year (as of the date I attend camp).
___ I would like to participate in Camp La-No-Che's Specialty Camp. I would like to take part in the following
Specialty Camp program: ____________________________________________________________________
Method of Payment (Fees do not include Accident and Sickness Insurance.) Make checks payable to Central
Florida Council and mail to Camp La-No-Che "Provo", P.O. Box 323, Paisley, FL 32767.
Cash or Check Check #
Amount $
Visa/Mastercard #
Expiration Date
/
/
Signature:
51
Section IX - Forms
Campsite Inspection Form
Sample form - subject to minor changes - actual form will be distributed at Sunday SM/SPL meeting
Unit: _______________
Week: __________
Campsite: ___________________________________
Campsite Inspection Item
Points
1. Duty roster posted and filled out completely
5
2. Fireguard chart posted and filled out completely
5
3. All lights off during the day
5
4. Garbage bag in garbage can
5
5. Latrine floors swept and clean
10
6. Toilets, urinals, showers, and sinks clean
10
7. Dry toilet paper in each stall, supplies in bucket
5
8. American (or troop's national) flag displayed
5
9. Troop flag displayed
5
10. Patrol flag(s) displayed
5
11. Campsite is free of hazards
10
12. Activity shelter clean and orderly
10
13. Campsite area clear of litter and trash
10
14. Tents clean and uniform
10
Total Points
52
100
Mon
Tue
Wed
Thu
Fri
Service & Spirit Award
Troop: _________
Week: _____
Senior Patrol Leader: ___________________________________
A troop living by the Scout Law in their community, providing service and exhibiting spirit, is an excellent example of leadership. Each member of your troop can earn a Camp La-No-Che Service & Spirit Patch by completing
the requirements below. You will sign up with the Camp Commissioner to provide service in the following areas.
Also, your troop will have opportunities to display their Scout Spirit. We look forward to seeing your troop earn
this very special patch and to have your Senior Patrol Leader recognized at the 8:30 p.m assembly on Friday before
the campfire, where he will be presented your patches. This form must be turned in by Friday at 12:30 p.m. to the
Camp Commissioner.
Service-Dining Hall (must complete 2 of 3 choices) (initial by dining hall staff)
Time
Initials
Kitchen service troop (serving line, dishes and trash) - each meal
Dining area service troop (wash tables, sweep and trash pickup)
Dining hall latrine cleanup - morning, afternoon, or evening
Service-Downtown Camp (must complete 2 of 3 choices) (initial by camp staff mgmt.)
Visitor latrine cleanup - morning, afternoon, or evening
Happy hour cleanup (downtown, campsite paths, or office/parking area)
Service-Program Area (pick one area with approval in advance from Quartermaster
or area director) (initial by quartermaster or area director)
Area of Service ________________________________________________________
Spirit-Opening, lunch or closing ceremony (must complete 2 items) (initial by unit leader)
Flag ceremony
Prayer
Troop spirit addition at ceremony (e.g., entering with a cheer, song, etc.)
Spirit-Campfire spirit (must complete 1 item at campfire Sunday or Thursday)
(initial by unit leader)
Troop shows spirit at Sunday campfire with cheers or other
Attend pow-wow with spirit on Thursday night at 8:30
Spirit-Troop spirit item (decided by your PLC to provide spirit to camp) (initial by
commissioner)
Item ______________________________________________________________
Our unit has completed this challenge of living by the Scout Law to provide camp service and increased our spirit
to promote a fun and exciting camp.
Date: _____________________ Scoutmaster signature: ______________________________________________
53
2013 This
Unit
Roster and Registration
form should be used only if not using online registration
Unit Type and Number:
District:
Unit Leader:
Council:
Address:
Home Phone:
City, State, Zip:
Work Phone:
Email:
Fax Number:
Adult Leader Roster
Name
(1*)
(2*)
(3)
(4)
* = Mandatory
Birth Date Days Attending Check to volunteer as
Adventure Camp Leader
(Additional leaders can be listed on the back of this form.)
Scout Roster
Name
Traditional(T), Adventure(A), Registration Other
or Specialty(S) Camp
Fee
Fees
(SPL)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(Additional Scouts can be listed on the back of this form.)
This form is to be mailed to the Camping Office with the May Payment
(For office use: account 1-6701-052-21)
Method of Payment (Fees do not include Accident and Sickness Insurance.) Make checks payable to Central
Florida Council and mail to Camp La-No-Che, P.O. Box 323, Paisley, FL 32767.
Cash or Check
Check #
Amount $
Visa/MC/Discover/
Amer.Express #
Expiration Date
/
/
Signature:
54
2013 Unit Roster
and Registration (continued)
This form should be used only if not using online registration
Adult Leader Roster (continued)
Name
Birth Date Days Attending Check to volunteer as
Adventure Camp Leader
(5)
(6)
(7)
(8)
Scout Roster (continued)
Name
Traditional(T), Adventure(A), Registration Other
or Specialty(S) Camp
Fee
Fees
(13)
(14)
(15)
(16)
(17)
(18)
(19)
(20)
(21)
(22)
(23)
(24)
(25)
(26)
(27)
(28)
(29)
(30)
(31)
(32)
(33)
(34)
(35)
(36)
(37)
(38)
(39)
(40)
55
2013ThisMerit
Badge Registration Form
form should be used only if not using online merit badge registration
We are limiting the size of merit badge courses in order to provide proper instruction. Camp is now accepting
pre-registration for merit badges and special skills courses. Courses will be filled on a first-come-first-served basis.
This will help ensure that the Scouts (and leaders) know the Scouts’ schedules, and will also give the summer camp
staff an idea of what the demands are for various merit badge courses.
Please indicate the merit badge course by name under the appropriate time. Keep in mind that some courses last
for more than one hour. Please mail this form to the camp office as early as possible prior to arrival at camp, starting
March 1, 2013, because class size is limited.
(Please copy as needed. The back of this form contains space for additional Scouts.)
Unit #:__________ District/Council:________________________________________ Camp Week:__________
Unit Leader Name:______________________ Phone #:______________ Email: _________________________
Scout's Name
9 am
10 am
11 am
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(13)
(14)
(15)
(16)
(17)
(18)
(19)
(20)
(Additional Scouts can be listed on the back of this form.)
56
1:30 pm
2:30 pm
2013 MeritThisBadge
Registration Form (continued)
form should be used only if not using online merit badge registration
Scout's Name
9 am
10 am
(21)
(22)
(23)
(24)
(25)
(26)
(27)
(28)
(29)
(30)
(31)
(32)
(33)
(34)
(35)
(36)
(37)
(38)
(39)
(40)
(41)
(42)
(43)
(44)
(45)
(46)
(47)
57
11 am
1:30 pm
2:30 pm
Long Term Campership Application
for Central Florida Council Scouts Attending Camp La-No-Che
All applications are considered based entirely on financial need and availability of funds. Money is made available by
private donors. Submit application to: Central Florida Council Campership Committee, 1941 S OBT, Apopka FL 32703.
Complete the following application, including all signatures, and mail it to the address given above. Certification of the Scoutmaster or Committee Chairman is required. Camperships are rarely given for more than half of the
camp fee since the Scout should earn part of the cost of attending camp. The Scout must be a registered Boy Scout in
Central Florida Council. Applications must be received no later than May 1, 2013 and will be reviewed in the order
in which they were received. The Central Florida Council Camp Program Committee will review the applications and
decide which camperships will be awarded. For all approved camperships, notification will be sent to the unit leader
listed below. If a campership is awarded, it may be used only for the Scout to whom it is given during the week listed
below. As part of the application, parents MUST describe the circumstances which justify the campership.
Please list the financial reasons which caused you to submit this application. The information will remain confidential.
This application will not be considered without the justification. I hereby apply for a campership for:
Name:
Troop:
Address:
District:
City, State, Zip:
Home Phone:
Email:
Amount Requested:
Did the troop provide a means to earn the fees? __Yes __No
Dates of Camp:
Did your son participate in the fund-raising? __Yes __No
Reason campership is needed (REQUIRED): ______________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
(continue reason on back of form or separate page, if needed)
Parent's Signature:
Date:
If the Scout is granted a campership, our troop will be responsible for helping him to obtain a physical exam,
transportation, and equipment needs.
Scoutmaster or Committee Chairman Signature:
Position:
Phone #:
Email:
58
Camp Volunteer Leader Application
Applications must be received by 05/01/13. You will be notified prior to your arrival at camp regarding your acceptance in this program.
Name:
Unit:
Address:
District:
City, State, Zip:
Home Phone:
Email:
Work Phone:
Prior Scouting Experience: __Cubs __Boy Scouts __Explorers
Unit Position:
Scout Training:
Week(s) Attending Camp:
Please check the subjects listed below in which you are qualified to instruct:
__ Electricity
__ Photography
__ Plumbing
__ Robotics
__ Auto Maintenance
__ Radio
__ Painting
__ Chess
__ Home Repairs
__ Electronics
__ Welding
__ Trailblazers
__ Pool / Lake
Camp Staff/Counselor-in-Training Application
We would like to offer the opportunity for Scouts and Scouters to apply for a position on the Camp La-No-Che
summer camp staff. If someone in your troop would like to apply, they should fill out the following form and mail it
to the address below. The camp staff needs area directors and merit badge counselors for the staff. Help make Camp
La-No-Che an unforgettable experience. Apply now and join our new and exciting camp staff. Please have your top
Scouts complete and mail this request before February 10, 2013. In order to apply, the Scout must be at least fifteen
years old at the start of camp and a counselor-in-training must be 14 years old.
Staff application is next page
59
The Leonard and Marjorie Williams Family Scout Reservation
Summer Camp 2013 Staff Application
NAME:___________________________________________________________________________
ADDRESS:________________________________________________________________________
CITY:__________________________________ STATE:________ ZIP:_____________________
PHONE #:______________________SOCIAL SECURITY #:______________________________
PARENT NAME:______________________ WORK PHONE #:___________________________
COLLEGE ADDRESS: ______________________________________________________________
CITY:______________________________ STATE:________________ ZIP:___________________
COLLEGE PHONE#:_________________________________________________________________
SCOUTING BACKGROUND:__________________________________________________________
TROOP#:__________________ TEAM #:__________________ POST #:_______________________
COUNCIL:______________________________
DISTRICT: ________________________
LENGTH OF TIME AS A BOY/GIRL SCOUT:______ LENGTH OF TIME AS A CUB SCOUT:________
LENGTH OF TIME AS AN ADULT LEADER:____________________________
CURRENT TROOP POSITION:________________________________ SCOUT RANK:_____________
NAME OF CURRENT LEADER:_______________________ PHONE #:_______________________
LIST ALL MERIT BADGES, CERTIFICATIONS, AND LEADERSHIP COURSES COMPLETED IN SCOUTING AND OTHER ORGANIZATIONS ALL SCOUTING MERIT BADGES AND CERTIFICATIONS MUST
HAVE UNIT LEADERS INITIALS BY THEM.
MERIT BADGES:
___________________ ____________________ ____________________ ____________________
___________________ ____________________ ____________________ ____________________
___________________ ____________________ ____________________ ____________________
___________________ ____________________ ____________________ ____________________
___________________ ____________________ ____________________ ____________________
___________________ ____________________ ____________________ ____________________
LEADERSHIP/CERTIFICATIONS:
DATE ATTENDED:
___________________________________________
________________
___________________________________________
________________
LIST SUMMER CAMP OR OTHER STAFF EXPERIENCES:
___________________________________________
WHEN:
________________
___________________________________________
________________
HIGH SCHOOL:_________________________________ GRADE LEVEL COMPLETED:_______
COLLEGE:______________________________________ YEARS COMPLETED: ______________
EMPLOYMENT HISTORY
CURRENT EMPLOYMENT:__________________________________________________________
SUPERVISOR:__________________________________
PHONE #:____________________
PREVIOUS EMPLOYMENT:__________________________________________________________
SUPERVISOR:__________________________________
PHONE #:____________________
PREVIOUS EMPLOYMENT:__________________________________________________________
SUPERVISOR:__________________________________
PHONE #:____________________
REFERENCES:
(PEOPLE THAT COULD BE CONTACTED FOR MORE INFO.)
(PLEASE TURN OVER & COMPLETE OTHER SIDE)60
NAME:_______________________________________ OCCUPATION:________________________________
HOME PHONE #:
WORK PHONE #:________________________
NAME:_______________________________________ OCCUPATION:_________________________________
HOME PHONE #:_______________________
WORK PHONE #:_________________________
POSITION PREFERENCE (instructions to follow):
1. Please rate the top three areas that you would be interested in working at summer camp (1 is top area, 2 is second choice & 3 is your third choice). They may be in any of the three area sections below.
2. Then please check the positions under the section you are interested and meet the minimum age requirement set
by the National Boy Scouts of America policy
TRADITIONAL CAMP AREAS:
AQUATICS:____ ECOLOGY: ___ HANDICRAFT:___ HEALTHCRAFT: ____ NATIVE AMER: ____
SCOUT CRAFT: ____ SHOOTING SPORTS: ____ TRAILBLAZERS: ___ UNIT SERVICE _____
Please check position interest that you meet the minimum age requirement as of June 1, 2013
Counselor in Training – CIT (MA 14): __________ Program Counselor (MA 15): _______
Senior Program Counselor (MA 17): _______
Assistant Area Director (MA 18): ________
Shooting Sports Range Officer (MA 18): _________
Area Director (MA 18): ________
Aquatics Director (MA 21): _________
PWC Instructor (MA 21): ________
ADVENTURE CAMP AREAS:
ADVENTURE TREKS: ________
CAMP ADVENTURE (Climbing/Cycling): ___________
COPE: _________ Alpine Tower: __________
Please check position interest that you meet the minimum age requirement as of June 1, 2013
Adventure Counselor in Training – CIT (MA: 16): _______ Adventure Counselor (MA 16): _________
Senior Adventure Counselor (MA 18): __________ Adventure Area Director (MA 18):_______
COPE Director (MA 21): _______ ATV Instructor: (MA 21): ________
ADMINISTRATION CAMP AREAS:
ADMINISTRATION: __________
HEALTH OFFICER: _________
Please check position interest that you meet the minimum age requirement as of June 1, 2013
Program Director (MA 21): ___________ Chaplain (MA 21): _________ Chaplain Aide (MA 16): ______
Provo Scoutmaster (MA 21): __________ Assistant Provo Scoutmaster (MA 18): __________
IF YOU HAVE WORKED AT SUMMER CAMP BEFORE WHAT WAS YOUR PREVIOUS SALARY?
$
/PER WEEK.
ALL EMPLOYEES SHOULD BE AVAILABLE FOR THE FULL SEASON
EXCEPTIONS MUST BE REQUESTED DURING INTERVIEWS
I know of no reason why my health would limit full Camp participation, and if employed I will provide an up-todate physical examination. I am/will be a registered member of the Boy Scouts of America. If selected, the Boy
Scouts of America can expect my loyalty to management, its policies, programs and my full cooperation with other
members of the staff. THIS APPLICATION NEEDS YOUR CURRENT UNIT LEADER AND PARENT SIGNATURE FOR ANYONE UNDER THE AGE OF 18 AS OF JANUARY 1, 2013. IF APPLICATION DOES NOT
HAVE BOTH IT WILL BE RETURNED AND NOT CONSIDERED!
_________________________________________
(Applicants signature)
(Date) ____________________________________________
(Parents signature if under 18)
(Date)
SCOUTMASTER SIGNATURE:____________________________________________________________
(Scoutmaster Signature)
(Date)
RETURN APPLICATION TO: CAMP DIRECTOR; WINN-DIXIE SCOUT RESERVATION; P.O. BOX 323;
PAISLEY, FL. 32767; Fax: (352) 669-7636 or E-Mail:[email protected]
AN EQUAL OPPORTUNITY EMPLOYER
61
2013 Camp La-No-Che News
Dear Parents:
We look forward to having your son spend a week with us at camp. As a camper, he should bring with him:
Enough clothes for a week at camp, including plenty of socks. We do a lot of walking and blisters are common.
Closed-toe shoes are to be worn at all times, and a spare pair of shoes is important.
• Field (“Class A”) uniform. A Scout should travel in field uniform, wear it to dinner each night, and have his
troop photograph taken in it.
• Swim suit and towels
• Long pants and a long sleeved button up shirt for boys taking any of the aquatics merit badges.
• Toilet articles: soap, toothbrush, toothpaste, comb, etc.
• Raincoat or poncho
• Flashlight
• Insect repellent
• Pocket knife
• Compass
• Sleeping bag or sheet and blanket. We will sleep on cots. For his sleeping comfort, he should bring a mosquito net.
• Scout handbook, merit badge books, paper, and pens
• If taking the Big Stump hike, he should bring clothes and shoes that can be thrown away after this very muddy hike.
• Spending money (No large amounts of cash)
• Locked trunk to store everything (or at least valuables).
•
Please don’t send unnecessary items to camp that might get broken, lost, or stolen. Label everything he
does bring. If you would like to write to your son, please address mail as follows:
Scout’s name
Troop __________
Camp La-No-Che
P.O. Box 323
Paisley, FL 32767
Thursday night is parents’ night. For a $7.00 you are welcome to have dinner with your son and see a special
program. Cub Scouts in uniform eat free. You may purchase dinner upon arrival at the check-in pavilion next to the
main parking area.
Thanks for letting your son have the opportunity to attend camp.
62
Annual Health and Medical Record
Registro Médico y de Salud Anual
(Valid for 12 calendar months)
(Válido por 12 meses calendario)
Policy on Use of the Annual Health
and Medical Record
Política para el uso del Registro Médico
y de Salud Anual
In order to provide better care for its members and to assist
them in better understanding their own physical capabilities,
the Boy Scouts of America recommends that everyone who
participates in a Scouting event have an annual medical
evaluation by a certified and licensed health-care provider—a
physician (MD or DO), nurse practitioner, or physician assistant.
Providing your medical information on this four-part form will
help ensure you meet the minimum standards for participation
in various activities. Note that unit leaders must always protect
the privacy of unit participants by protecting their medical
information.
A fin de proporcionar una mejor atención para sus miembros
y para ayudarles a entender mejor sus propias capacidades
físicas, Boy Scouts of America recomienda que todos aquellos
que participen en un evento Scouting se sometan a un examen
médico anual realizado por un prestador de servicios de salud
certificado y con licencia: un médico (Doctor en medicina o
Doctor en osteopatía), enfermera profesional o asistente médico.
Proporcionar su información médica en este formulario de cuatro
partes, ayudará a asegurar que usted cumple con los estándares
mínimos de participación en varias actividades. Tome en cuenta
que los líderes de unidad siempre deben proteger la privacidad
de los participantes al salvaguardar su información médica.
Parts A and B are to be completed at least annually by
participants in all Scouting events. This health history, parental/
guardian informed consent and release agreement, and
talent release statement is to be completed by the participant
and parents/guardians. Attach a copy of both sides of your
insurance card.
Part C is the pre-participation physical exam that is required
for participants in any event that exceeds 72 consecutive
hours, for all high-adventure base participants, or when the
nature of the activity is strenuous and demanding. Service
projects or work weekends may fit this description. Part C is
to be completed and signed by a certified and licensed heathcare provider—physician (MD or DO), nurse practitioner, or
physician assistant. It is important to note that the height/
weight limits must be strictly adhered to when the event will
take the unit more than 30 minutes away from an emergency
vehicle, accessible roadway, or when the program requires
it, such as backpacking trips, high-adventure activities, and
conservation projects in remote areas. See the FAQs for when
this does not apply.
Part D is required to be reviewed by all participants of a highadventure program at one of the national high-adventure bases,
as well as unit-based, high-adventure backcountry activities,
and shared with the examining health-care provider before
completing Part C.
• Philmont Scout Ranch. Participants and guests for Philmont
activities that are conducted with limited access to the
backcountry, including most Philmont Training Center
conferences and family programs, will not require completion
of Part C. However, participants should review Part D to
understand potential risks inherent at 6,700 feet in elevation
in a dry Southwest environment. Please review specific
registration information for the activity or event.
• Northern Tier National High Adventure Base.
• Florida National High Adventure Sea Base. The PADI medical
form is also required if scuba diving at this base.
• Summit Bechtel Reserve.
Las Partes A y B las deben completar, por lo menos una vez
al año, los participantes de todos los eventos Scouting. Este
historial médico, notificación de consentimiento y convenio de
exoneración de responsabilidad por parte de los padres/tutores,
y formulario de cesión de derechos lo deben completar los
participantes y los padres/tutores. Anexar una copia de ambos
lados de su tarjeta del seguro.
La Parte C es el examen físico previo, que se requiere de
los participantes de cualquier evento que exceda 72 horas
consecutivas, para todos los participantes de las bases de
aventura extrema, o cuando la naturaleza de la actividad es
extenuante y exigente. Los proyectos de servicio o fines de
semana de trabajo pueden caer en esta descripción. La Parte
C la debe completar y firmar un prestador de servicios de salud
certificado y con licencia: un médico (Doctor en medicina o
Doctor en osteopatía), enfermera profesional o asistente médico.
Es importante tomar en cuenta que los límites de estatura y peso
deben ser estrictamente controlados cuando el evento llevará a
la unidad a más de 30 minutos de un vehículo de emergencia,
camino accesible, o cuando el programa lo requiera, tal como
expediciones, actividades de aventura extrema y proyectos
de conservación en áreas remotas. Consulte las Preguntas
Frecuentes para cuando estos lineamientos no aplican.
La Parte D se requiere que la revisen todos los participantes del
programa de aventura extrema en una de las bases nacionales de
aventura extrema, así como actividades de aventura extrema en
zonas aisladas basadas en la unidad, y que la compartan con el
prestador de servicios de salud antes de completar la Parte C.
• Rancho Scout Philmont. Los participantes e invitados en las
actividades Philmont que se realicen con acceso limitado a las
zonas campestres, incluyendo la mayoría de las conferencias
y programas familiares en el Centro de Capacitación Philmont,
no requerirán llenar la Parte C. Sin embargo, los participantes
deberán repasar la Parte D para entender los riesgos
potenciales inherentes a los 6,700 pies de elevación en un
ambiente seco del Suroeste. Favor de revisar la información
de registro específica para la actividad o evento.
• Base nacional de aventura extrema Northern Tier.
• Base nacional marina de aventura extrema de la Florida.
También se requiere el formulario médico PADI si se va a
bucear en esta base.
• Summit Bechtel Reserve.
63
Risk Factors
Based on the vast experience of the medical community, the
BSA has identified the following risk factors that may limit your
participation in various outdoor adventures.
• Excessive body weight
• Heart disease
• Hypertension (high blood
pressure)
• Diabetes
• Seizures
• Lack of appropriate
immunizations
• Asthma
• Allergies/anaphylaxis
• Muscular/skeletal
injuries
• Psychiatric/
psychological and
emotional difficulties
Factores de riesgo
Con base en la gran experiencia de la comunidad médica, BSA
ha identificado los siguientes factores de riesgo que podrían
limitar su participación en varias aventuras al aire libre.
• Peso corporal excesivo
• Enfermedad cardiaca
• Hipertensión (Presión
arterial alta)
• Diabetes
• Convulsiones
• Falta de vacunación
adecuada
• Asma
• Alergias/anafilaxia
• Lesiones musculares/
óseas
• Trastornos psiquiátricos/
psicológicos y
emocionales
For more information on medical risk factors, visit Scouting
Safely on www.scouting.org.
Para obtener más información sobre los factores de riesgo
médicos, visite Scouting Safely en www.scouting.org.
Prescriptions
The taking of prescription medication is the responsibility of the
individual taking the medication and/or that individual’s parent or
guardian. A leader, after obtaining all the necessary information,
can agree to accept the responsibility of making sure a youth takes
the necessary medication at the appropriate time, but the BSA
does not mandate or necessarily encourage the leader to do so.
Also, if state laws are more limiting, they must be followed.
Prescripciones
Tomar los medicamentos prescritos es responsabilidad del
individuo que requiere el medicamento o del padre de familia
o tutor del individuo. Un líder, después de haber obtenido toda
la información necesaria, puede aceptar la responsabilidad de
asegurarse de que un niño tome el medicamento necesario a la
hora apropiada, pero BSA no obliga ni necesariamente anima
al líder a que lo haga. Asimismo, si las leyes estatales son más
limitantes, deben ser cumplidas.
Frequently Asked Questions (FAQs)
• PhilmontScoutRanch:www.philmontscoutranch.org or
575-376-2281
• NorthernTierNationalHighAdventureProgram:
www.ntier.org or 218-365-4811
• FloridaNationalHighAdventureSeaBase:
www.bsaseabase.org or 305-664-5612
• NationalScoutjamboree:www.bsajamboree.org
• SummitBechtelReserve:www.summitblog.org or
304-250-6750
For frequently asked questions about this Annual Health and
MedicalRecord,seeScoutingSafelyonlineat
http://www.scouting.org/scoutsource/HealthandSafety.
aspx. Information about the Health Insurance Portability and
Accountability Act (HIPAA) may be found at www.hhs.gov/ocr/
privacy/.
Preguntas frecuentes
• RanchoScoutPhilmont:www.philmontscoutranch.org
ó 575-376-2281
• BasenacionaldeaventuraextremaNorthernTier:
www.ntier.org ó 218-365-4811
• BasenacionalmarinadeaventuraextremadelaFlorida:
www.bsaseabase.org ó 305-664-5612
• JamboreeScoutNacional:www.bsajamboree.org
• SummitBechtelReserve:www.summitblog.org
ó 304-250-6750
ParaconsultarlaspreguntasfrecuentessobreesteRegistro
Médico y de Salud Anual, consulte Scouting Safely en línea en
http://www.scouting.org/scoutsource/HealthandSafety.aspx. La
información sobre la Ley de responsabilidad y transferibilidad de
seguros médicos (HIPAA, por sus siglas en inglés) se encuentra
en www.hhs.gov/ocr/privacy/.
64
680-001
2012 Printing
Rev.9/2012
Teléfono en caso de emergencia
Allergies: __________________ Emergency contact No.: _____________
Fecha de nacimiento Alergias
Full name: ________________________________ DOB: _______________
Parte A Nombre completo
Part A
Annual Health and Medical Record
Registro Médico y de Salud Anual
Part A/Parte A
High-adventure base participants:
Participantes en la base de aventura extrema:
Expedition/crew No.
Expedición/grupo no.: ______________________________
or staff position
o puesto fijo: _____________________________________
GENERAL INFORMATION/INFORMACIÓN GENERAL
Name ___________________________________________________ Date of birth __________________________________ Age ___________
Nombre
Fecha de nacimiento
(MM/DD/Year) - (MM/DD/Año)
Male
Edad
Masculino
Female
Femenino
Address _____________________________________________________________________________________________ Grade completed (youth only) _____________________
Domicilio
Grado escolar completado (sólo niños)
City _________________________________________________________ State _____________ Zip _____________________ Phone No. ______________________________
Ciudad
Estado
Código postal
No. telefónico
Unit leader ___________________________________________________ Council name/No. __________________________________________ Unit No. __________________
Líder de la unidad
Nombre y no. del concilio
No. de unidad
Social Security No. (optional; may be required by medical facilities for treatment) __________________________________ Religious preference _______________________
No. de Seguro Social (opcional; puede ser solicitado por las instalaciones médicas para brindar tratamiento)
Preferencia religiosa
Health/accident insurance company ___________________________________________________________ Policy No. _______________________________________________
Compañía de seguro médico/accidental
No. de póliza
ATTACH A PHOTOCOPY OF BOTH SIDES OF INSURANCE CARD. IF YOU DO NOT HAVE MEDICAL INSURANCE, ENTER “NONE” ABOVE.
ANEXAR UNA FOTOCOPIA DE AMBOS LADOS DE LA TARJETA DEL SEGURO. SI USTED NO TIENE SEGURO MÉDICO, ESCRIBA “NINGUNO.”
In case of emergency, notify/En caso de emergencia, notificar a:
Name ________________________________________________________________________________ Relationship ___________________________________________________
Nombre
Parentesco
Address ______________________________________________________________________________________________________________________________________________
Domicilio
Home phone ________________________________________ Business phone ____________________________________ Mobile phone ______________________________
Teléfono de casa
Teléfono de oficina
Teléfono móvil
Alternate contact name ____________________________________________________________________ Alternate’s phone __________________________________________
Nombre de contacto alterno
Teléfono del contacto alterno
HEALTH HISTORY/HISTORIAL MÉDICO
Please fill in the bubbles as indicated below:
Por favor rellene los círculos tal como se indica a continuación:
Do you currently have, or have you ever been treated for any of the following?
Correct:
Incorrect:
¿Tiene actualmente, o ha tenido alguna vez los siguientes?
Incorrecto
Yes/Sí
No/No
Correcto
Condition/Padecimiento
Asthma
Asma
Diabetes
Diabetes
Explain/Explique
Last attack: (MM/YY)
Último ataque: (MM/AA)
%
Last HbA1c: (Percentage)
Última HbA1c: (Porcentaje)
Hypertension (high blood pressure)
Hipertensión (presión alta)
Heart disease/heart attack/chest pain/heart murmur
Enfermedad del corazón/infarto/dolores de pecho/soplo cardíaco
Stroke/TIA
Apoplejía/Accidente isquémico transitorio
Lung/respiratory disease
Enfermedades pulmonares/respiratorias
Ear/sinus problems
Problemas del oído/senos paranasales
Muscular/skeletal condition
Condiciones musculares/óseas
Menstrual problems (women only)
Problemas menstruales (sólo mujeres)
Psychiatric/psychological and emotional difficulties
Dificultades psiquiátricas/psicológicas y emocionales
Behavioral/neurological disorders
Trastornos de conducta/neurológicos
Bleeding disorders
Enfermedades hemorrágicas
Fainting spells
Desmayos
Thyroid disease
Enfermedades de la tiroides
Kidney disease
Enfermedades del riñón
Sickle cell disease
Anemia falciforme
Seizures
Convulsiones
Last seizure: (MM/YY)
Última convulsión: (MM/AA)
Sleep disorders (e.g., sleep apnea)
Trastornos del sueño (por ejemplo, síndrome de apnea-hipopnea durante el sueño)
Use CPAP:
Usa CPAP
Yes
Sí
No
No
Abdominal/digestive problems
Problemas abdominales/digestivos
Surgery
Cirugía
Last surgery: (MM/YY)
Última cirugía: (MM/AA)
Serious injury
Lesión grave
Excessive fatigue or shortness of breath with exercise
Fatiga en exceso o dificultad para respirar al hacer ejercicio
Other
Otro
Page 1 of 2
65
PART A (continued on next page)
HEALTH HISTORY/HISTORIAL MÉDICO
Please fill in the bubbles as indicated:
Are you allergic to or do you have any adverse reaction to any of the following?
Por favor rellene los círculos tal como se indica:
¿Es alérgico a, o le causa alguna reacción adversa cualquiera de los siguientes?
Yes/Sí
Correct:
Incorrecto
Correcto
Explain
Allergies or Reaction to
No/No
Incorrect:
Alergias o Reacciones a
Explique
Medication
Medicamentos
Food, plants, or insect bites
Alimentos, plantas o picaduras de insectos
The following immunizations are recommended by the BSA. Tetanus immunization is required and must have been received within the last 10 years. For each
item, indicate if you have been immunized, the date of the immunization (MM/YY), if you have had the disease, and the date (MM/YY).
BSA recomienda las siguientes vacunas. La vacuna contra el Tétanos es obligatoria y debe haberla recibido en los últimos 10 años. Por cada punto, indique si ha sido vacunado, la fecha
en que la recibió (MM/AA), si ha padecido la enfermedad, y la fecha (MM/AA).
Immunized?
Immunizations
¿Vacunado?
Yes/Sí
Date (MM/YY)
Fecha (MM/AA)
Vacunas
No/No
Had Disease?
Date (MM/YY)
¿La ha padecido?
Yes/Sí
Fecha (MM/AA)
No/No
Tetanus
Tétano
Pertussis
DOB: ___________________
Fecha de nacimiento
Tos ferina
Diphtheria
Difteria
Measles
Sarampión
Mumps
Paperas
Rubella
Rubéola
Polio
Polio
Chicken pox
Varicela
Hepatitis A
Hepatitis A
Hepatitis B
Hepatitis B
Meningitis
Part A
Full name: _________________________________________________________
Parte A Nombre completo
Meningitis
Influenza
Influenza
Other (i.e., HIB)
Otra (por ejemplo, HIB)
Exemption to immunizations claimed (form required).
Exención de vacunas solicitada (formulario obligatorio).
MEDICATIONS List all medications currently used. (If additional space is needed, please photocopy this part of the
health form.) Inhalers and EpiPen information must be included, even if they are for occasional or emergency use only.
Sin medicamentos
MEDICAMENTOS Enumere todos los medicamentos que usa en la actualidad. (Si requiere espacio adicional, favor de sacar una fotocopia de esta
parte del formulario.) Se debe incluir información sobre inhaladores y EpiPen, incluso si son sólo para uso ocasional o en caso de emergencia.
Medicamentos adicionales (hoja anexa)
Medication
Medicamento _________________________________________
Strength
Frequency
Dosis ____________________ Frecuencia ________________
Medication
Medicamento _________________________________________
Strength
Frequency
Dosis ____________________ Frecuencia ________________
No medications
Additional medications (sheet attached)
Medication
Medicamento _________________________________________
Strength
Frequency
Dosis ____________________ Frecuencia ________________
Approximate date started
Approximate date started
Approximate date started
Reason for medication
Reason for medication
Reason for medication
______________________________________________________
______________________________________________________
______________________________________________________
Medication
Medication
Medication
Fecha aproximada de inicio _____________________________
Razón del medicamento ________________________________
Medicamento _________________________________________
Strength
Frequency
Dosis ____________________ Frecuencia ________________
Fecha aproximada de inicio _____________________________
Razón del medicamento ________________________________
Medicamento _________________________________________
Strength
Frequency
Dosis ____________________ Frecuencia ________________
Fecha aproximada de inicio _____________________________
Razón del medicamento ________________________________
Medicamento _________________________________________
Strength
Frequency
Dosis ____________________ Frecuencia ________________
Approximate date started
Approximate date started
Approximate date started
Reason for medication
Reason for medication
Reason for medication
______________________________________________________
______________________________________________________
______________________________________________________
Fecha aproximada de inicio _____________________________
Razón del medicamento ________________________________
Fecha aproximada de inicio _____________________________
Razón del medicamento ________________________________
Fecha aproximada de inicio _____________________________
Razón del medicamento ________________________________
Administration of the above medications
is approved by (if required by your state): _________________________________________________________/ _______________________________________________________
La administración de los medicamentos arriba
mencionados está aprobada por (si lo requiere su estado)
Parent/guardian signature
Firma del padre o tutor
and/or
y/o
MD/DO, NP, or PA signature
Firma del Dr., Enfermera
profesional, Asistente médico
Bring enough medications in sufficient quantities and in the original containers. Make sure that they are NOT expired, including inhalers
and EpiPens. You SHOULD NOT STOP taking any maintenance medication unless instructed to do so by your doctor.
Asegurarse de traer los medicamentos en cantidades suficientes y en los envases originales. Asegurarse de que NO ESTÉN
CADUCADOS, incluyendo inhaladores y EpiPens. NO DEBE DEJAR DE tomar cualquier medicamento de mantenimiento a menos
que se lo indique su médico.
Page 2 of 2
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High-adventure base participants:
Participantes en la base de aventura extrema:
Part B
Full name: _________________________________________________________
Parte B Nombre completo
DOB: ___________________
Fecha de nacimiento
Part B/Parte B
Expedition/crew No./Expedición/grupo no.: ______________________________
or staff position/o puesto fijo: ___________________________________________
Informed Consent and release agreement
notIfICaCIÓn de ConsentImIento Y eXoneraCIÓn de resPonsaBIlIdad
I understand that participation in Scouting activities involves
a certain degree of risk and can be physically, mentally, and
emotionally demanding. I also understand that participation in
these activities is entirely voluntary and requires participants to
abide by applicable rules and standards of conduct.
Entiendo que la participación en actividades Scouting implica un cierto
grado de riesgo y que pueden ser física, mental y emocionalmente
agotadoras. Asimismo, entiendo que la participación en dichas actividades
es completamente voluntaria y requiere que los participantes se acaten a
las reglas y estándares de conducta pertinentes.
In case of an emergency involving me or my child, I understand
that every effort will be made to contact the individual listed as the
emergency contact person. In the event that this person cannot
be reached, permission is hereby given to the medical provider
selected by the adult leader in charge to secure proper treatment,
including hospitalization, anesthesia, surgery, or injections of
medication for me or my child. Medical providers are authorized to
disclose protected health information to the adult in charge, camp
medical staff, camp management, 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 yo, o mi hijo, nos veamos involucrados en un caso de
emergencia, entiendo que se hará todo lo posible para contactar al
individuo mencionado como persona a contactar en caso de emergencia.
En caso de que dicha persona no pueda ser localizada, por este medio
otorgo permiso al proveedor de servicios médicos seleccionado por el
líder adulto a cargo para asegurar que se proporcione el tratamiento
adecuado, incluyendo hospitalización, anestesia, cirugía o inyecciones
de medicamentos para mí o mi hijo. Los proveedores médicos están
autorizados a compartir información médica protegida con el adulto
a cargo, el personal médico del campamento, la administración del
campamento, o cualquier médico o proveedor de servicios médicos
involucrado en la administración de atención médica al participante. La
Información médica 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, incluye resultados
de reconocimientos médicos, resultados de pruebas y tratamiento
proporcionado para propósitos de evaluación médica del participante,
seguimiento y comunicación con los padres o tutor del participante,
y determinación de la habilidad del participante de continuar con las
actividades del programa.
I have carefully considered the risk involved and give consent for
myself and/or my child to participate in these activities. I approve
the sharing of the information on this form with BSA volunteers
and professionals who need to know of medical situations that
might require special consideration for the safe conducting of
Scouting activities.
I release the Boy Scouts of America, the local council, the activity
coordinators, and all employees, volunteers, related parties, or
other organizations associated with the activity from any and all
claims or liability arising out of this participation.
He considerado cuidadosamente el riesgo implicado y he dado el
consentimiento para mí mismo o mi hijo de participar en dichas
actividades. Apruebo que se comparta la información contenida en este
formulario con los voluntarios y profesionales de BSA que necesiten tener
conocimiento de condiciones médicas que puedan requerir consideración
especial para la realización de actividades Scouting de manera segura.
Eximo a Boy Scouts of America, al concilio local, a los coordinadores de la
actividad y a todos los empleados, voluntarios, grupos involucrados u otras
organizaciones asociadas con la actividad, de cualquier y toda reclamación
o responsabilidad que surja a raíz de esta participación.
Without restrictions./Sin restricciones.
With special considerations or restrictions (list)/Con condiciones especiales o restricciones (lista):
________________________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________________________
I hereby assign and grant to the local council and the Boy Scouts
of America the right and permission to use and publish the
photographs/film/videotapes/electronic representations and/or
sound recordings made of me or my child at all Scouting activities,
and I hereby release the Boy Scouts of America, the local council,
the activity coordinators, and all employees, volunteers, related
parties, or other organizations associated with the activity from any
and all liability from such use and publication.
Por este conducto asigno y otorgo al concilio local y a Boy Scouts of
America el derecho y permiso para usar y publicar las fotografías/películas/
videocintas/representaciones electrónicas y grabaciones de sonido de mí
o mi hijo realizadas en todas las actividades Scouting, y por este medio
exonero a Boy Scouts of America, al concilio local, a los coordinadores
de la actividad y a todos los empleados, voluntarios, grupos involucrados
u otras organizaciones asociadas con la actividad, de cualquier y toda
responsabilidad por dicho uso y publicación.
I hereby authorize the reproduction, sale, copyright, exhibit,
broadcast, electronic storage, and/or distribution of said
photographs/film/videotapes/electronic representations and/
or sound recordings without limitation at the discretion of the
Boy Scouts of America, and I specifically waive any right to any
compensation I may have for any of the foregoing.
Por este conducto autorizo la reproducción, venta, derechos reservados,
exhibición, transmisión, almacenamiento electrónico y distribución de
dichas fotografías/películas/ videocintas/representaciones electrónicas
y grabaciones de sonido sin limitación a discreción de Boy Scouts
of America, y específicamente renuncio a cualquier derecho de
compensación alguna que pueda tener por cualquiera de lo anterior.
Yes/Sí
No/No
Page 1 of 2
67
PART B (continued on next page)
ADULTS AUTHORIZED TO TAKE YOUTH TO AND FROM EVENTS:
You must designate at least one adult. Please include a
telephone number.
ADULTOS AUTORIZADOS PARA TRANSPORTAR AL NIÑO HACIA Y DESDE
LOS EVENTOS:
Debe designar por lo menos a un adulto. Por favor incluya un número telefónico.
1. Name/Nombre __________________________________________________________________________Telephone/Teléfono ________________________
2. Name/Nombre __________________________________________________________________________Telephone/Teléfono ________________________
3. Name/Nombre __________________________________________________________________________Telephone/Teléfono ________________________
Adults NOT authorized to take youth to and from events/Adultos NO autorizados para transportar al niño hacia y desde los eventos:
1. Name/Nombre __________________________________________________________________________Telephone/Teléfono ________________________
2. Name/Nombre __________________________________________________________________________Telephone/Teléfono ________________________
DOB: ___________________
Fecha de nacimiento
3. Name/Nombre __________________________________________________________________________Telephone/Teléfono ________________________
I understand that, if any information I/we have provided is
found to be inaccurate, it may limit and/or eliminate the
opportunity for participation in any event or activity.
Entiendo que, si cualquier información que he/hemos proporcionado
es errónea, puede limitar o eliminar la oportunidad de participación en
cualquier evento o actividad.
If I am participating at Philmont, Philmont Training Center,
Northern Tier, Florida Sea Base, or the Summit Bechtel
Reserve: I have also read and understand the risk advisories
explained in Part D, including height and weight requirements
and restrictions, and understand that the participant will
not be allowed to participate in applicable high-adventure
programs if those requirements are not met. The participant
has permission to engage in all high-adventure activities
described, except as specifically noted by me or the healthcare provider. If the participant is under the age of 18, a parent
or guardian’s signature is required.
Si participo en Philmont, el Centro de Capacitación Philmont,
Northern Tier, la Base Marina de la Florida o Summit Bechtel Reserve:
También he leído y entiendo las advertencias de riesgo explicadas
en la Parte D, incluyendo los requisitos y restricciones de estatura y
peso, y entiendo que al participante no se le permitirá intervenir en
programas de aventura extrema si dichos requisitos no se cumplen.
El participante tiene permiso de intervenir en todas las actividades
de aventura extrema descritas, excepto aquellas específicamente
señaladas por mí o el proveedor de servicios médicos. Si el
participante es menor de 18 años, se requiere la firma de el padre/
madre o tutor.
Participant’s name/Nombre del participante _____________________________________________________________________________________________
Date/Fecha
Part B
Full name: _________________________________________________________
Parte B Nombre completo
Participant’s signature/Firma del participante
Parent/guardian’s signature/Firma del padre o tutor
(if participant is under the age of 18/si el participante es menor de 18 años)
Second parent/guardian signature/Firma del otro padre o tutor
(if required; for example, CA/si se requiere; por ejemplo en CA)
Date/Fecha
Date/Fecha
This Annual Health and Medical Record is valid for 12 calendar months.
Este Registro Médico y de Salud Anual tiene vigencia por 12 meses calendario.
Page 2 of 2
68
680-001
2012 Printing
Rev. 9/2012
Part C/Parte C
Pre-participation Physical
Examen físico previo a la participación
High-adventure base participants:
Participantes en la base de aventura extrema:
Expedition/crew No.
Expedición/grupo no.: ______________________________
or staff position
o puesto fijo: _____________________________________
TO THE EXAMINING HEALTH CARE PROVIDER
PARA EL PROVEEDOR DE SERVICIOS DE SALUD QUE
REALICE EL RECONOCIMIENTO (Médicos certificados y
(Certified and licensed physicians [MD, DO], nurse practitioners, and
physician assistants)
You are being asked to certify that this individual has no contraindication
for participation in a Scouting experience as described in Part D. For
individuals who will be attending a high-adventure program, either unitbased or at one of the national high-adventure bases, please refer to
Part D for additional information.
Height (inches)
Weight (pounds)
Estatura (pulgadas)
DOB: ___________________
Fecha de nacimiento
Maximum weight for height
Peso (libras)
Blood pressure
Part C Full name: _________________________________________________________
Parte C Nombre completo
licenciados, enfermeras profesionales y asistentes médicos)
Se les está solicitando que certifiquen que este individuo no tiene
contraindicación para participar en una experiencia Scouting tal como
se describe en la Parte D. Para individuos que estarán participando en
un programa de aventura extrema, ya sea en la unidad o en una de las
bases nacionales de aventura extrema, por favor consulte la Parte D para
información adicional.
Pulse
Presión arterial
Porcentaje de grasa
corporal (opcional)
If you exceed the maximum weight for height as explained on the next
page and your planned high-adventure activity will take you more than
30 minutes away from an emergency vehicle/accessible roadway, you
will not be allowed to participate. At the discretion of the medical
advisers of the event and/or camp, participation of an individual
exceeding the maximum weight for height may be allowed if the body
fat percentage measured by the health care provider is determined
to be 20 percent or less for a female or 15 percent or less for a male.
(Philmont requires a hydrostatic weighing or DXA test to be used for
this determination.) Please call the event leader and/or camp if you
have any questions. Enforcing the height/weight guidelines is strongly
encouraged for all other events.
Examiner: Please fill in the information.
Examinador: Favor de completar la información.
Normal
Please fill in the bubbles as indicated:
Por favor rellene los círculos tal como se indica:
Range of Mobility
Explique cualquier anomalía
Rango de movilidad
Eyes
Knees (both)
Ears
Ankles (both)
Nose
Spine
Ojos
Yes/Sí
No/No
Si usted excede el peso máximo para su estatura tal como se explica
en la siguiente página y su actividad de aventura extrema planeada
le llevará a más de 30 minutos de distancia de una vía con acceso
para un vehículo de emergencia, usted no podrá participar. A juicio
de los consejeros médicos del evento o campamento, la participación
de un individuo que exceda el peso máximo para su estatura puede
permitirse si el porcentaje de grasa corporal medida por el proveedor
de servicios de salud determina que es 20 por ciento o menos para una
mujer o 15 por ciento o menos para un hombre. (Philmont requiere que
se use una prueba de peso hidrostático o de densitometría ósea para
determinarlo). Por favor llame al líder del evento o del campamento si
tiene preguntas. El cumplimiento de los lineamientos de estatura y peso
se recomienda encarecidamente para todos los demás eventos.
Abnormal Explain Any Abnormalities
Anormal
Cumple con los límites
de estatura/peso
Percent body fat (optional)
Pulso
Normal
Meets height/
weight limits
Máximo peso para la estatura
Incorrect:
Correct:
Incorrecto
Normal
Normal
Correcto
Abnormal Explain Any Abnormalities
Anormal
Explique cualquier anomalía
Rodillas (ambas)
Oídos
Tobillos (ambos)
Nariz
Espina
Throat
Garganta
Lungs
Pulmones
Neurological
Other
Yes
Otro
Neurológico
Sí
Heart
Personal or family
history of heart disease
Abdomen
Medical equipment
(i.e., CPAP, oxygen)
Genitalia/hernia
Contacts
Skin
Dentures
Emotional
adjustment
Braces
Corazón
No
Explain
Explique
Historial personal o familiar
de enfermedad cardíaca
Abdomen
Equipo médico (por
ejemplo, CPAP, oxígeno)
Genitales/hernia
Lentes de contacto
Piel
Dentaduras
Tratamientos de
ortodoncia
Ajuste emocional
Tuberculosis (TB) skin test (if required by your state for BSA camp staff):
Negative/Negativo
Prueba de Tuberculosis (TB) (si lo requiere su estado para personal del campamento BSA)
Allergies/Alergias:
No
No/No
Positive/Positivo
Yes/Sí (explain to what agent, type of reaction, treatment/explique a qué agente, tipo de reacción, tratamiento):
___________________________________________________________________________________________________________________________________
Medical restrictions to participate/Restricciones médicas para participar:
No/No
Yes/Sí (explain/explique):
___________________________________________________________________________________________________________________________________
Page 1 of 2
69
PART C (continued on next page)
EXAMINER’S CERTIFICATION
CERTIFICACIÓN
DEL EXAMINADOR
Height
(inches)
Estatura
(pulgadas)
Recommended
Weight (lbs)
Peso recomendado
(libras)
Allowable
Exception
Maximum
Acceptance
60
97-138
139-166
166
61
101-143
144-172
172
62
104-148
149-178
178
63
107-152
153-183
183
64
111-157
158-189
189
65
114-162
163-195
195
Cumple con los requisitos de estatura/peso
66
118-167
168-201
201
Does not have uncontrolled heart disease,
asthma, or hypertension
67
121-172
173-207
207
68
125-178
179-214
214
69
129-185
186-220
220
I certify that I have reviewed the health history and examined
this person and find no contraindications for participation
in a Scouting experience. This participant (with noted
restrictions above):
Certifico que he revisado el historial médico, examinado a esta persona
y no encuentro contradicciones para su participación en una experiencia
Scouting. Este participante (con las restricciones descritas anteriormente):
Please fill in the bubbles as indicated:
Por favor rellene los círculos tal como se indica:
True
Cierto
False
Falso
Incorrect:
Incorrecto
Correct:
Correcto
Meets height/weight requirements
Part C Full name: _________________________________________________________
Parte C Nombre completo
DOB: ___________________
Fecha de nacimiento
No tiene cardiopatía, asma o hipertensión incontrolados
Has not had an orthopedic injury,
musculoskeletal problems, or orthopedic
surgery in the last six months or possesses a
letter of clearance from his or her orthopedic
surgeon or treating physician
Excepción
permitida
Aceptación
máxima
70
132-188
189-226
226
No ha tenido una lesión ortopédica, problemas
musculoesqueléticos o cirugía ortopédica en los últimos
seis meses o posee una carta de autorización por parte
de su cirujano ortopédico o médico
71
136-194
195-233
233
72
140-199
200-239
239
Has no uncontrolled psychiatric disorders
73
144-205
206-246
246
Has had no seizures in the last year
74
148-210
211-252
252
Does not have poorly controlled diabetes
75
152-216
217-260
260
76
156-222
223-267
267
77
160-228
229-274
274
78
164-234
235-281
281
79 & over
170-240
241-295
295
No tiene trastornos psiquiátricos incontrolados
No ha tenido convulsiones en el último año
No tiene diabetes mal controlada
If less than 18 years of age and planning to
scuba dive, does not have diabetes, asthma,
or seizures
Si tiene menos de 18 años de edad y piensa realizar
buceo, no tiene diabetes, asma o convulsiones
I have reviewed Part D for high-adventure
activities.
He revisado la Parte D para actividades de aventura
extrema.
Provider printed name
Nombre del proveedor _______________________________________________
Address
This table is based on the revised Dietary Guidelines for Americans from the
U.S. Dept. of Agriculture and the Dept. of Health & Human Services.
Esta tabla está basada en los Lineamientos dietéticos para estadounidenses del
Departamento de Agricultura de los EE.UU. y del Departamento de Salud y
Servicios Humanos.
Domicilio ___________________________________________________________
DO NOT WRITE IN THIS BOX
NO ESCRIBA EN ESTE RECUADRO
City, state, zip
Ciudad, estado, código postal ________________________________________
Office phone
REVIEW FOR CAMP OR SPECIAL ACTIVITY/REVISIÓN PARA CAMPAMENTO O
ACTIVIDAD ESPECIAL
Date
Reviewed by
Revisado por _____________________________________________________________
Teléfono del consultorio ______________________________________________
Fecha _____________________________________________________________
Examiner signature in the box below.
Firma del examinador en el recuadro de abajo.
Date
Fecha ___________________________________________________________________
Further approval required
Se requiere aprobación adicional
Yes
Sí
No
No
Reason
Razón ____________________________________________________________________
Approved by
Aprobado por _____________________________________________________________
Date
Fecha ___________________________________________________________________
Click here for more information regarding high-adventure outings or go to www.scouting.org/filestore/HealthSafety/pdf/part_d.pdf.
Haga clic aquí para obtener más información sobre las excursiones de aventura extrema o visite www.scouting.org/filestore/HealthSafety/pdf/
part_d.pdf.
Page 2 of 2
70
680-001
2012 Printing
Rev. 9/2012
MEDICAL STATEMENT
Participant Record (Confidential Information)
Please read carefully before signing.
This is a statement in which you are informed of some potential risks
involved in scuba diving and of the conduct required of you during the
scuba training program. Your signature on this statement is required for
you to participate in the scuba training program offered
by_____________________________________________________and
Instructor
_______________________________________________located in the
Facility
city of_______________________, state/province of _______________.
Read this statement prior to signing it. You must complete this
Medical Statement, which includes the medical questionnaire section, to
enroll in the scuba training program. If you are a minor, you must have
this Statement signed by a parent or guardian.
Diving is an exciting and demanding activity. When performed
correctly, applying correct techniques, it is relatively safe. When
established safety procedures are not followed, however, there are
increased risks.
To scuba dive safely, you should not be extremely overweight or
out of condition. Diving can be strenuous under certain conditions. Your
respiratory and circulatory systems must be in good health. All body air
spaces must be normal and healthy. A person with coronary disease, a
current cold or congestion, epilepsy, a severe medical problem or who is
under the influence of alcohol or drugs should not dive. If you have
asthma, heart disease, other chronic medical conditions or you are taking medications on a regular basis, you should consult your doctor and
the instructor before participating in this program, and on a regular basis
thereafter upon completion. You will also learn from the instructor the
important safety rules regarding breathing and equalization while scuba
diving. Improper use of scuba equipment can result in serious injury. You
must be thoroughly instructed in its use under direct supervision of a
qualified instructor to use it safely.
If you have any additional questions regarding this Medical
Statement or the Medical Questionnaire section, review them with your
instructor before signing.
Divers Medical Questionnaire
To the Participant:
The purpose of this Medical Questionnaire is to find out if you should be examined by your doctor before participating in recreational diver training. A positive
response to a question does not necessarily disqualify you from diving. A positive
response means that there is a preexisting condition that may affect your safety
while diving and you must seek the advice of your physician prior to engaging in
dive activities.
Please answer the following questions on your past or present medical history
with a YES or NO. If you are not sure, answer YES. If any of these items apply to
you, we must request that you consult with a physician prior to participating in
scuba diving. Your instructor will supply you with an RSTC Medical Statement and
Guidelines for Recreational Scuba Diver’s Physical Examination to take to your
physician.
_____ Could you be pregnant, or are you attempting to become pregnant?
_____ Dysentery or dehydration requiring medical intervention?
_____ Are you presently taking prescription medications? (with the exception of
birth control or anti-malarial)
_____ Any dive accidents or decompression sickness?
_____ Are you over 45 years of age and can answer YES to one or more of the
following?
• currently smoke a pipe, cigars or cigarettes
• have a high cholesterol level
• have a family history of heart attack or stroke
• are currently receiving medical care
• high blood pressure
• diabetes mellitus, even if controlled by diet alone
Have you ever had or do you currently have…
_____ Asthma, or wheezing with breathing, or wheezing with exercise?
_____ Frequent or severe attacks of hayfever or allergy?
_____ Frequent colds, sinusitis or bronchitis?
_____ Any form of lung disease?
_____ Pneumothorax (collapsed lung)?
_____ Other chest disease or chest surgery?
_____ Behavioral health, mental or psychological problems (Panic attack, fear of
closed or open spaces)?
_____ Epilepsy, seizures, convulsions or take medications to prevent them?
_____ Recurring complicated migraine headaches or take medications to prevent them?
_____ Blackouts or fainting (full/partial loss of consciousness)?
_____ Frequent or severe suffering from motion sickness (seasick, carsick,
etc.)?
_____ Inability to perform moderate exercise (example: walk 1.6 km/one mile
within 12 mins.)?
_____ Head injury with loss of consciousness in the past five years?
_____ Recurrent back problems?
_____ Back or spinal surgery?
_____ Diabetes?
_____ Back, arm or leg problems following surgery, injury or fracture?
_____ High blood pressure or take medicine to control blood pressure?
_____ Heart disease?
_____ Heart attack?
_____ Angina, heart surgery or blood vessel surgery?
_____ Sinus surgery?
_____ Ear disease or surgery, hearing loss or problems with balance?
_____ Recurrent ear problems?
_____ Bleeding or other blood disorders?
_____ Hernia?
_____ Ulcers or ulcer surgery ?
_____ A colostomy or ileostomy?
_____ Recreational drug use or treatment for, or alcoholism in the past five
years?
The information I have provided about my medical history is accurate to the best of my knowledge. I agree to accept
responsibility for omissions regarding my failure to disclose any existing or past health condition.
_______________________________________ _________________
Signature
Date
71 _______________________________________
Signature of Parent or Guardian
PRODUCT NO. 10063 (Rev. 06/07) Ver. 2.01
Page 1 of 6
_________________
Date
© PADI 1989, 1990, 1998, 2001, 2007
© Recreational Scuba Training Council, Inc. 1989, 1990, 1998, 2001, 2007
STUDENT
Please print legibly.
Name__________________________________________________________________________
First
Initial
Last
Birth Date ________________ Age ________
Day/Month/Year
Mailing Address __________________________________________________________________________________________________________
City________________________________________________________________ State/Province/Region ________________________________
Country ____________________________________________________________
Home Phone (
)________________________________________
Zip/Postal Code _____________________________________
Business Phone (
Email _____________________________________________________
)______________________________________
FAX_______________________________________________________
Name and address of your family physician
Physician __________________________________________________
Clinic/Hospital ______________________________________________
Address________________________________________________________________________________________________________________
Date of last physical examination ________________
Name of examiner____________________________________________
Clinic/Hospital_______________________________________________
Address ________________________________________________________________________________________________________________
Phone (
)___________________________________
Were you ever required to have a physical for diving?
Yes
Email ________________________________________________________________
No
If so, when?________________________________________________
PHYSICIAN
This person applying for training or is presently certified to engage in scuba (self-contained underwater breathing apparatus) diving. Your opinion of
the applicant’s medical fitness for scuba diving is requested. There are guidelines attached for your information and reference.
Physician’s Impression
I find no medical conditions that I consider incompatible with diving.
I am unable to recommend this individual for diving.
Remarks ___________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
__________________________________________________________________________ Date ___________________________
Physician’s Signature or Legal Representative of Medical Practitioner
Day/Month/Year
Physician_____________________________________________
Clinic/Hospital_________________________________________
Address____________________________________________________________________________________________________
Phone (
)___________________________________
Email ________________________________________________________________
72
Page 2 of 6
Guidelines for Recreational Scuba Diver’s Physical Examination
Instructions to the Physician:
Recreational SCUBA (Self-Contained Underwater Breathing
Apparatus) can provide recreational divers with an enjoyable
sport safer than many other activities. The risk of diving is
increased by certain physical conditions, which the relationship to
diving may not be readily obvious. Thus, it is important to screen
divers for such conditions.
The RECREATIONAL SCUBA DIVER’S PHYSICAL EXAMINATION focuses on conditions that may put a diver at increased risk
for decompression sickness, pulmonary overinflation syndrome
with subsequent arterial gas embolization and other conditions
such as loss of consciousness, which could lead to drowning.
Additionally, the diver must be able to withstand some degree of
cold stress, the physiological effects of immersion and the optical
effects of water and have sufficient physical and mental reserves
to deal with possible emergencies.
The history, review of systems and physical examination should
include as a minimum the points listed below. The list of conditions that might adversely affect the diver is not all-inclusive, but
contains the most commonly encountered medical problems. The
brief introductions should serve as an alert to the nature of the
risk posed by each medical problem.
The potential diver and his or her physician must weigh the
pleasures to be had by diving against an increased risk of death
or injury due to the individual’s medical condition. As with any
recreational activity, there are no data for diving enabling the calculation of an accurate mathematical probability of injury. Experience and physiological principles only permit a qualitative
assessment of relative risk.
For the purposes of this document, Severe Risk implies that an
individual is believed to be at substantially elevated risk of decompression sickness, pulmonary or otic barotrauma or altered consciousness with subsequent drowning, compared with the general population. The consultants involved in drafting this document
would generally discourage a student with such medical problems from diving. Relative Risk refers to a moderate increase in
risk, which in some instances may be acceptable. To make a
decision as to whether diving is contraindicated for this category
of medical problems, physicians must base their judgement on
an assessment of the individual patient. Some medical problems
which may preclude diving are temporary in nature or responsive to treatment, allowing the student to dive safely after they
have resolved.
Diagnostic studies and specialty consultations should be obtained
as indicated to determine the diver’s status. A list of references is
included to aid in clarifying issues that arise. Physicians and
other medical professionals of the Divers Alert Network (DAN)
associated with Duke University Health System are available for
consultation by phone +1 919 684 2948 during normal business
hours. For emergency calls, 24 hours 7 days a week, call +1 919
684 8111 or +1 919 684 4DAN (collect). Related organizations
exist in other parts of the world – DAN Europe in Italy +39 039
605 7858, DAN S.E.A.P. in Australia +61 3 9886 9166 and Divers
Emergency Service (DES) in Australia +61 8 8212 9242, DAN
Japan +81 33590 6501 and DAN Southern Africa +27 11 242
0380. There are also a number of informative websites offering
similar advice.
NEUROLOGICAL
Neurological abnormalities affecting a diver’s ability to perform
exercise should be assessed according to the degree of compromise. Some diving physicians feel that conditions in which there
can be a waxing and waning of neurological symptoms and
signs, such as migraine or demyelinating disease, contraindicate
diving because an exacerbation or attack of the preexisting disease (e.g.: a migraine with aura) may be difficult to distinguish
from neurological decompression sickness. A history of head
injury resulting in unconsciousness should be evaluated for risk
of seizure.
Relative Risk Conditions
• Complicated Migraine Headaches whose symptoms or
severity impair motor or cognitive function, neurologic
manifestations
• History of Head Injury with sequelae other than seizure
• Herniated Nucleus Pulposus
• Intracranial Tumor or Aneurysm
• Peripheral Neuropathy
• Multiple Sclerosis
• Trigeminal Neuralgia
• History of spinal cord or brain injury
Temporary Risk Condition
History of cerebral gas embolism without residual where pulmonary air trapping has been excluded and for which there
is a satisfactory explanation and some reason to believe that
the probability of recurrence is low.
Severe Risk Conditions
Any abnormalities where there is a significant probability of
unconsciousness, hence putting the diver at increased risk of
drowning. Divers with spinal cord or brain abnormalities where
perfusion is impaired may be at increased risk of decompression
sickness.
Some conditions are as follows:
• History of seizures other than childhood febrile seizures
• History of Transient Ischemic Attack (TIA) or Cerebrovascular Accident (CVA)
• History of Serious (Central Nervous System, Cerebral or
Inner Ear) Decompression Sickness with residual deficits
CARDIOVASCULAR SYSTEMS
Relative Risk Conditions
The diagnoses listed below potentially render the diver unable to
meet the exertional performance requirements likely to be
encountered in recreational diving. These conditions may lead
the diver to experience cardiac ischemia and its consequences.
Formalized stress testing is encouraged if there is any doubt
regarding physical performance capability. The suggested minimum criteria for stress testing in such cases is at least 13
METS.* Failure to meet the exercise criteria would be of significant concern. Conditioning and retesting may make later qualification possible. Immersion in water causes a redistribution of
blood from the periphery into the central compartment, an effect
that is greatest in cold water. The marked increase in cardiac
preload during immersion can precipitate pulmonary edema in
patients with impaired left ventricular function or significant valvular disease. The effects of immersion can mostly be gauged by
an assessment of the diver’s performance while swimming on the
surface. A large proportion of scuba diving deaths in North America are due to coronary artery disease. Before being approved to
scuba dive, individuals older than 40 years are recommended to
undergo risk assessment for coronary artery disease. Formal
exercise testing may be needed to assess the risk.
* METS is a term used to describe the metabolic cost. The MET at rest
is one, two METS is two times the resting level, three METS is three
times the resting level, and so on. The resting energy cost (net oxygen
requirement) is thus standardized. (Exercise Physiology; Clark, Prentice
Hall, 1975.)
73
Page 3 of 6
Relative Risk Conditions
• Obesity
• History of Coronary Artery Bypass Grafting (CABG)
• Percutaneous Balloon Angioplasty (PCTA) or Coronary
Artery Disease (CAD)
• History of Myocardial Infarction
• Congestive Heart Failure
• Hypertension
• History of dysrythmias requiring medication for suppression
• Valvular Regurgitation
• History of Immersion Pulmonary Edema Restrictive Disease*
• Interstitial lung disease: May increase the risk of pneumothorax
* Spirometry should be normal before and after exercise
Active Reactive Airway Disease, Active Asthma, Exercise
Induced Bronchospasm, Chronic Obstructive Pulmonary
Disease or history of same with abnormal PFTs or a positive
exercise challenge are concerns for diving.
Pacemakers
The pathologic process that necessitated should be
addressed regarding the diver’s fitness to dive. In those
instances where the problem necessitating pacing does not
preclude diving, will the diver be able to meet the performance criteria?
* NOTE: Pacemakers must be certified by the manufacturer as able
to withstand the pressure changes involved in recreational diving.
Severe Risks
PULMONARY
Any process or lesion that impedes airflow from the lungs places
the diver at risk for pulmonary overinflation with alveolar rupture
and the possibility of cerebral air embolization. Many interstitial
diseases predispose to spontaneous pneumothorax: Asthma
(reactive airway disease), Chronic Obstructive Pulmonary Disease (COPD), cystic or cavitating lung diseases may all cause air
trapping. The 1996 Undersea and Hyperbaric Medical Society
(UHMS) consensus on diving and asthma indicates that for the
risk of pulmonary barotrauma and decompression illness to be
acceptably low, the asthmatic diver should be asymptomatic and
have normal spirometry before and after an exercise test.
Inhalation challenge tests (e.g.: using histamine, hypertonic
saline or methacholine) are not sufficiently standardized to be
interpreted in the context of scuba diving.
A pneumothorax that occurs or reoccurs while diving may be catastrophic. As the diver ascends, air trapped in the cavity
expands and could produce a tension pneumothorax.
In addition to the risk of pulmonary barotrauma, respiratory disease due to either structural disorders of the lung or chest wall or
neuromuscular disease may impair exercise performance. Structural disorders of the chest or abdominal wall (e.g.: prune belly),
or neuromuscular disorders, may impair cough, which could be
life threatening if water is aspirated. Respiratory limitation due to
disease is compounded by the combined effects of immersion
(causing a restrictive deficit) and the increase in gas density,
which increases in proportion to the ambient pressure (causing
increased airway resistance). Formal exercise testing may be
helpful.
• History of Asthma or Reactive Airway Disease (RAD)*
• History of Exercise Induced Bronchospasm (EIB)*
• History of solid, cystic or cavitating lesion*
• Pneumothorax secondary to:
-Thoracic Surgery
-Trauma or Pleural Penetration*
-Previous Overinflation Injury*
• History of spontaneous pneumothorax. Individuals who
have experienced spontaneous pneumothorax should avoid
diving, even after a surgical procedure designed to prevent
recurrence (such as pleurodesis). Surgical procedures either
do not correct the underlying lung abnormality (e.g.: pleurodesis, apical pleurectomy) or may not totally correct it (e.g.: resection of blebs or bullae).
• Impaired exercise performance due to respiratory disease.
Venous emboli, commonly produced during decompression,
may cross major intracardiac right-to-left shunts and enter
the cerebral or spinal cord circulations causing neurological
decompression illness. Hypertrophic cardiomyopathy and
valvular stenosis may lead to the sudden onset of unconsciousness during exercise.
Relative Risk Conditions
Severe Risk Conditions
GASTROINTESTINAL
Temporary Risks
As with other organ systems and disease states, a process which
chronically debilitates the diver may impair exercise performance.
Additionally, dive activities may take place in areas remote from
medical care. The possibility of acute recurrences of disability or
lethal symptoms must be considered.
Temporary Risk Conditions
• Peptic Ulcer Disease associated with pyloric obstruction or
severe reflux
• Unrepaired hernias of the abdominal wall large enough to
contain bowel within the hernia sac could incarcerate.
Relative Risk Conditions
• Inflammatory Bowel Disease
• Functional Bowel Disorders
Severe Risks
Altered anatomical relationships secondary to surgery or malformations that lead to gas trapping may cause serious problems.
Gas trapped in a hollow viscous expands as the divers surfaces
and can lead to rupture or, in the case of the upper GI tract, emesis. Emesis underwater may lead to drowning.
Severe Risk Conditions
• Gastric outlet obstruction of a degree sufficient to produce
recurrent vomiting
• Chronic or recurrent small bowel obstruction
• Severe gastroesophageal reflux
• Achalasia
• Paraesophageal Hernia
ORTHOPAEDIC
Relative impairment of mobility, particularly in a boat or ashore
with equipment weighing up to 18 kgs/40 pounds must be
assessed. Orthopaedic conditions of a degree sufficient to impair
exercise performance may increase the risk.
Relative Risk Conditions
• Amputation
• Scoliosis must also assess impact on respiratory function
and exercise performance.
• Aseptic Necrosis possible risk of progression due to
effects of decompression (evaluate the underlying medical
Page 4 of 6
74
cause of decompression may accelerate/escalate the progression).
Temporary Risk Conditions
• Back pain
HEMATOLOGICAL
Abnormalities resulting in altered rheological properties may theoretically increase the risk of decompression sickness. Bleeding
disorders could worsen the effects of otic or sinus barotrauma,
and exacerbate the injury associated with inner ear or spinal cord
decompression sickness. Spontaneous bleeding into the joints
(e.g.: in hemophilia) may be difficult to distinguish from decompression illness.
OTOLARYNGOLOGICAL
Equalisation of pressure must take place during ascent and
descent between ambient water pressure and the external auditory canal, middle ear and paranasal sinuses. Failure of this to
occur results at least in pain and in the worst case rupture of the
occluded space with disabling and possible lethal consequences.
The inner ear is fluid filled and therefore noncompressible. The
flexible interfaces between the middle and inner ear, the round
and oval windows are, however, subject to pressure changes.
Previously ruptured but healed round or oval window membranes
are at increased risk of rupture due to failure to equalise pressure
or due to marked overpressurisation during vigorous or explosive
Valsalva manoeuvres.
Relative Risk Conditions
•
•
•
•
•
•
•
•
personal fears
Claustrophobia and agoraphobia
Active psychosis
History of untreated panic disorder
Drug or alcohol abuse
Sickle Cell Disease
Polycythemia Vera
Leukemia
Hemophilia/Impaired Coagulation
METABOLIC AND ENDOCRINOLOGICAL
With the exception of diabetes mellitus, states of altered hormonal or metabolic function should be assessed according to their
impact on the individual’s ability to tolerate the moderate exercise
requirement and environmental stress of sport diving. Obesity
may predispose the individual to decompression sickness, can
impair exercise tolerance and is a risk factor for coronary artery
disease.
The larynx and pharynx must be free of an obstruction to airflow.
The laryngeal and epiglotic structure must function normally to
prevent aspiration.
Mandibular and maxillary function must be capable of allowing
the patient to hold a scuba mouthpiece. Individuals who have
had mid-face fractures may be prone to barotrauma and rupture
of the air filled cavities involved.
Relative Risk Conditions
Relative Risk Conditions
• Hormonal Excess or Deficiency
• Obesity
• Renal Insufficiency
•
•
•
•
•
•
•
•
•
Severe Risk Conditions
The potentially rapid change in level of consciousness associated with hypoglycemia in diabetics on insulin therapy or
certain oral hypoglycemic medications can result in drowning. Diving is therefore generally contraindicated, unless
associated with a specialized program that addresses these
issues. [See “Guidelines for Recreational Diving with Diabetes”
at www/wrstc.com and www.diversalertnetwork.org.]
Pregnancy: The effect of venous emboli formed during
decompression on the fetus has not been thoroughly investigated. Diving is therefore not recommended during any
stage of pregnancy or for women actively seeking to
become pregnant.
BEHAVIORAL HEALTH
Behavioral: The diver’s mental capacity and emotional make-up
are important to safe diving. The student diver must have sufficient learning abilities to grasp information presented to him by
his instructors, be able to safely plan and execute his own dives
and react to changes around him in the underwater environment.
The student’s motivation to learn and his ability to deal with
potentially dangerous situations are also crucial to safe scuba
diving.
Relative Risk Conditions
•
•
•
•
Developmental delay
History of drug or alcohol abuse
History of previous psychotic episodes
Use of psychotropic medications
Severe Risk Conditions
• Inappropriate motivation to dive – solely to please spouse,
partner or family member, to prove oneself in the face of
•
•
•
•
•
•
•
Recurrent otitis externa
Significant obstruction of external auditory canal
History of significant cold injury to pinna
Eustachian tube dysfunction
Recurrent otitis media or sinusitis
History of TM perforation
History of tympanoplasty
History of mastoidectomy
Significant conductive or sensorineural hearing impairment
Facial nerve paralysis not associated with barotrauma
Full prosthedontic devices
History of mid-face fracture
Unhealed oral surgery sites
History of head and/or neck therapeutic radiation
History of temperomandibular joint dysfunction
History of round window rupture
Severe Risk Conditions
•
•
•
•
•
•
•
•
•
•
•
•
•
Monomeric TM
Open TM perforation
Tube myringotomy
History of stapedectomy
History of ossicular chain surgery
History of inner ear surgery
Facial nerve paralysis secondary to barotrauma
Inner ear disease other than presbycusis
Uncorrected upper airway obstruction
Laryngectomy or status post partial laryngectomy
Tracheostomy
Uncorrected laryngocele
History of vestibular decompression sickness
Page 5 of 6
75
BIBLIOGRAPHY/REFERENCE
1.
Bennett, P. & Elliott, D (eds.)(1993). The Physiology and Medicine
of Diving. 4th Ed., W.B. Saunders Company Ltd., London, England.
2.
Bove, A., & Davis, J. (1990). Diving Medicine. 2nd Edition, W.B.
Saunders Company, Philadelphia, PA.
3.
4.
5.
6.
7.
8.
Neuman, T. & Bove, A. (1994). “Asthma and Diving.” Ann. Allergy,
Vol. 73, October, O’Conner & Kelsen.
9.
Shilling, C. & Carlston, D. & Mathias, R. (eds) (1984). The
Physician’s Guide to Diving Medicine. Plennum Press, New York,
NY.
10. Undersea and Hyperbaric Medical Society (UHMS)
www.UHMS.org
Davis, J., & Bove, A. (1986). “Medical Examination of Sport Scuba
Divers, Medical Seminars, Inc.,” San Antonio, TX
11. Divers Alert Network (DAN) United States, 6 West Colony Place,
Durham, NC www.DiversAlertNetwork.org
Dembert, M. & Keith, J. (1986). “Evaluating the Potential Pediatric
Scuba Diver.” AJDC, Vol. 140, November.
12. Divers Alert Network Europe, P.O. Box 64026 Roseto, Italy, telephone non-emergency line: weekdays office hours +39-085-8930333, emergency line 24 hours: +39-039-605-7858
Edmonds, C., Lowry, C., & Pennefether, J. (1992) .3rd ed., Diving
and Subaquatic Medicine. Butterworth & Heineman Ltd., Oxford,
England.
13. Divers Alert Network S.E.A.P., P. O. Box 384, Ashburton, Australia, telephone 61-3-9886-9166
Elliott, D. (Ed) (1994). “Medical Assessment of Fitness to Dive.”
Proceedings of an International Conference at the Edinburgh Conference Centre, Biomedical Seminars, Surry, England.
14. Divers Emergency Service, Australia, www.rah.sa.gov.au/hyperbaric, telephone 61-8-8212-9242
15. South Pacific Underwater Medicine Society (SPUMS), P.O. Box
190, Red Hill South, Victoria, Australia, www.spums.org.au
“Fitness to Dive,” Proceedings of the 34th Underwater & Hyperbaric
Medical Society Workshop (1987) UHMS Publication Number
70(WS-FD) Bethesda, MD.
16. European Underwater and Baromedical Society, www.eubs.org
ENDORSERS
Paul A. Thombs, M.D., Medical Director
Hyperbaric Medical Center
St. Luke’s Hospital, Denver, CO, USA
Peter Bennett, Ph.D., D.Sc.
Professor, Anesthesiology
Duke University Medical Center
Durham, NC, USA
[email protected]
Richard E. Moon, M.D., F.A.C.P., F.C.C.P.
Departments of Anesthesiology and Pulmonary
Medicine
Duke University Medical Center
Durham, NC, USA
Roy A. Myers, M.D.
MIEMS
Baltimore, MD, USA
William Clem, M.D., Hyperbaric Consultant
Division Presbyterian/St. Luke’s Medical Center
Denver, CO, USA
John M. Alexander, M.D.
Northridge Hospital
Los Angeles, CA, USA
Des Gorman, B.Sc., M.B.Ch.B., F.A.C.O.M.,
F.A.F.O.M., Ph.D.
Professor of Medicine
University of Auckland, Auckland, NZ
[email protected]
Alf O. Brubakk, M.D., Ph.D.
Norwegian University of Science and Technology
Trondheim, Norway
[email protected]
Alessandro Marroni, M.D.
Director, DAN Europe
Roseto, Italy
Hugh Greer, M.D.
Santa Barbara, CA, USA
[email protected]
Christopher J. Acott, M.B.B.S., Dip. D.H.M.,
F.A.N.Z.C.A.
Physician in Charge, Diving Medicine
Royal Adelaide Hospital
Adelaide, SA 5000, Australia
Chris Edge, M.A., Ph.D., M.B.B.S., A.F.O.M.
Nuffield Department of Anaesthetics
Radcliffe Infirmary
Oxford, United Kingdom
[email protected]
Richard Vann, Ph.D.
Duke University Medical Center
Durham, NC, USA
Keith Van Meter, M.D., F.A.C.E.P.
Assistant Clinical Professor of Surgery
Tulane University School of Medicine
New Orleans, LA, USA
Robert W. Goldmann, M.D.
St. Luke’s Hospital
Milwaukee, WI, USA
Simon Mitchell, MB.ChB., DipDHM, Ph.D.
Wesley Centre for Hyperbaric Medicine
Medical Director
Sandford Jackson Bldg., 30 Chasely Street
Auchenflower, QLD 4066 Australia
[email protected]
Jan Risberg, M.D., Ph.D.
NUI, Norway
Karen B.Van Hoesen, M.D.
Associate Clinical Professor
UCSD Diving Medicine Center
University of California at San Diego
San Diego, CA, USA
Edmond Kay, M.D., F.A.A.F.P.
Dive Physician & Asst. Clinical Prof. of Family Medicine
University of Washington
Seattle, WA, USA
[email protected]
Christopher W. Dueker, TWS, M.D.
Atherton, CA, USA
[email protected]
Paul G. Linaweaver, M.D., F.A.C.P.
Santa Barbara Medical Clinic
Undersea Medical Specialist
Santa Barbara, CA, USA
James Vorosmarti, M.D.
6 Orchard Way South
Rockville, MD, USA
Tom S. Neuman, M.D., F.A.C.P., F.A.C.P.M.
Associate Director, Emergency Medical Services
Professor of Medicine and Surgery
University of California at San Diego
San Diego, CA, USA
Yoshihiro Mano, M.D.
Professor
Tokyo Medical and Dental University
Tokyo, Japan
[email protected]
Page 6 of 6
76
Charles E. Lehner, Ph.D.
Department of Surgical Sciences
University of Wisconsin
Madison, WI, USA
[email protected]
Undersea & Hyperbaric Medical Society
10531 Metropolitan Avenue
Kensington, MD 20895, USA
Diver’s Alert Network (DAN)
6 West Colony Place
Durham, NC 27705
Unit Swim Classifications
Swim tests outside of summer camp may only be administered by an Aquatics Instructor, BSA,
Aquatics Supervisor, BSA or Adult BSA Lifeguard.
This is the individual’s swim classification as of the test date. Any change in swim status after this
date would require a reclassification test by the Aquatics Director. Swim tests should be given every
year. Please refer to the Guide to Safe Scouting for test administration.
When swim tests are conducted away from camp, the Aquatics Director shall reserve the authority to
review or retest.
Unit #
Participant’s Full Name
Non-swimmer
Swim Classification
Beginner
swimmer
1)
2)
3)
4)
5)
6)
7)
8)
9)
10)
11)
12)
13)
14)
15)
16)
17)
18)
19)
20)
_________________________________________
Test Administrator
__________________________________________
Location of Swim test
_________________________________________
Type of Certification
_________________________________________
Date of test
_________________________________________
Certification expiration date
_________________________________________
Aquatics director approval
Please attach a copy of certification card
77
Location of Camp
78
The Leonard and Marjorie Williams Family
Scout Reservation
41940 Boy Scout Road
Paisley, FL 32767
352-669-8558 voice
352-669-7636 fax
79
Map and Directions to Camp
Note: All distances are approximate. Origination point is assumed to be Orlando.
Directions
• Take I-4 east to SR 46 / exit 101BC.
• Turn left onto 46 and proceed west for 7.6 miles to SR 46A.
• Turn right onto 46A and proceed 5.5 miles to SR 44.
• Turn left onto 44 and proceed west 4.1 miles to CR 439.
• Turn right onto 439 and proceed 7.8 miles to CR 42.
• Turn right on 42. Proceed east 3.3 miles.
• Turn right on Maggie Jones Road (just past the Boy Scout Camp sign on 42).
• Follow the signs to Camp La-No-Che and The Leonard and Marjorie Williams Family Scout Reservation
80
Additional Map and Directions to Camp
Note: All distances are approximate. Origination point is assumed to be traveling along Interstate 75.
Directions if driving south along I-75
• Take I-75 to the exit for Belleview (exit 341). Turn left at CR484 E/SW CR 484 and proceed 2.3 miles.
• Turn right at S Highway 475/CR 475 and proceed 3.0 miles.
• Turn left at CR 42 and proceed 30.0 miles.
• Turn right at SR 19 for 440 feet.
• Turn left on CR 42. Proceed east 6.8 miles.
• Turn right on Maggie Jones Road (just past the Boy Scout Camp sign on 42).
• Follow the signs to Camp La-No-Che and The Leonard and Marjorie Williams Family Scout Reservation
Directions if driving north along I-75
• Take I-75 to the exit for Wildwood (exit 329). Merge onto SR 44 and proceed 3.5 miles
• Turn left at S Main St. / SR 35 / US 301 and proceed for 9.4 miles.
• Turn right at S Highway CR 42 and proceed 25.2 miles.
• Turn right at SR 19 for 440 feet.
• Turn left on CR 42. Proceed east 6.8 miles.
• Turn right on Maggie Jones Road (just past the Boy Scout Camp sign on 42).
• Follow the signs to Camp La-No-Che and The Leonard and Marjorie Williams Family Scout Reservation
81
Map of Camp
82

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