Scouts Canada
Southwestern Ontario Administrative Centre
Serving the Tri-Shores and Battlefields Councils
Adult Participating Form
To support the Screening Process of Special Events
This form is to be completed by all adults who are volunteering their services to an event in Tri-Shores or Battlefields
Councils who are not registered with the most local Group, Area or Council that is hosting the event. For full screening
information, please refer to Scouts Canada’s By-Laws, Policies and Procedures, Section 3000.
Personal Information
First Name
Last Name
Scouts Canada MMS Number
Street Address
City/Town
Postal Code
Mailing Address if different than above
Home Phone #
Business Telephone
Cell Number
Scouting Background
Are you currently a member of Scouts Canada, B.P. Guild or another National Scout Association?
Group
Area
Council
If you are a former member, please provide some background information on you experience
Group/Area/Council/Country
Positions Held
In What Year
Have your membership ever been terminated from Scouts Canada?
Please Select
Has your membership ever been refused by Scouts Canada?
Please Select
Based on the Police Record Check requirement, could you
Please Select
become a member of Scouts Canada?
See Reverse Side of this form
Please provide us the name and telephone number
of the Area Commissioner (or equivalent) for Scouting
for the Area in which you reside:
This form is to be submitted to the event host with the
SWO Administrative Centre Use Only
application to attend the event. It is the responsibility of the
Reviewed by:
event host to submit this form to the Southwestern Ontario
Administrative Centre for further verification.
This must be
Date:
done no less then four weeks prior to event date.
Comments/Action