Fillable Bsa Tour And Activity Plan Template (Page 2 of 2) in pdf

Tour involves:

Swimming

Boating

Climbing

Orienta

hts (attach Flying Plan required)

Wilderness or backcountry (must carry Wilderness Use Policy and follow principles of Leave No Trace)

Shooting

Other (specify)

Activity Standards: Where swimming or boating is included in the program, Safe Swim Defense and/or Safety A oat are to be followed. If

climbing/rappelling is included, then Climb On Safely must be followed. At least one person must be current in CPR/AED from any recognized

agency to meet Safety A

at and Climb On Safely guidelines. At least one adult on a pack overnighter must have completed Basic Adult Leader

Outdoor Orientation (BALOO). At least one adult must have completed Planning and Preparing for Hazardous Weather training for all tours and

activities. Trek Safely and Basic First Aid are recommended for all tours, and Wilderness First Aid is recommended for all backcountry tours.

Expiration date of commitment card/training (two years from completion date)

Name

Age

Youth

Planning and

BALOO

Climb On Safely

Safe Swim

Safety A

Protection

Preparing

(no

Defense

for Hazardous

expiration)

Weather

Name

Age

CPR Cer

ation/Agency

CPR Expiration

First-Aid Cer

ation/Agency

First Aid

Date

Expiration Date

Name

Age

NRA Instructor and/or RSO

No. _______

Shotgun

Pistol (Venturing only)

Range Safety O cer

Muzzle-loading r

Muzzle-loading shotgun

No. _______

Shotgun

Pistol (Venturing only)

Range Safety O cer

Muzzle-loading r

Muzzle-loading shotgun

Unauthorized and Restricted Activities: The BSA’s general liability insurance policy provides coverage for bodily injury or property damage

that arises out of an o cial Scouting activity as d ned by the Guide to Safe Scouting. Volunteers, units, chartered organizations, and local

councils that engage in unauthorized activities are jeopardizing their insurance coverage. PLEASE DO NOT PUT YOURSELF AT RISK.

INSURANCE

All vehicles MUST be covered by a liability and property damage insurance policy. The amount of this coverage must meet or exceed the

insurance requirement of the state in which the vehicle is licensed and comply with or exceed the requirements of the country of destination for

travel outside the United States. It is recommended, however, that coverage limits are a $100,000 combined single limit. Any vehicle designed

to carry 10 or more passengers is required to have a $500,000 combined single limit. In the case of rented vehicles, the requirement of coverage

limits can be met by combining the limits of personal coverage carried by the driver with coverage carried by the owner of the rented vehicle.

If the vehicle to be used is designed to carry more than 15 people (including the driver), the driver must have a valid commercial driver’s license

(CDL). In some states (California, for example), this policy applies to drivers of vehicles designed to carry 10 or more people.

All vehicles used in travel outside the United States must carry a public liability and property damage liability insurance policy that complies

with or exceeds the requirements of that country. Attach an additional page if more space is required.

Name ___________________________________________________________ CDL expires ___________________________________________

VALID

LIABILITY INSURANCE COVERAGE

DRIVER’S

DRIVER/OWNER

MAKE

MODEL

YEAR

LICENSE

Combined Single Limit

(Y or N)

680-014

Guide to Tour Planning Principles

2011 Printing

Rev. 12/2011

Bsa Tour And Activity Plan Template Page 2

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