Bsa/red Cross Lifeguard Mini-Camp Reservation Form - Bsa - 2016

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Cimarron Council, BSA
Boy Scouts of America
BSA/Red Cross Lifeguard Mini-Camp
Thursday, June 2 – Sunday, June 5 2016
 
Will Rogers Scout Reservation (Cleveland, OK)
What?
This mini-camp is designed for older Boy Scouts, Venturers and adult leaders wishing to become BSA and/or Red
Cross Lifeguards. Participants must be 15 years old or older, registered in a Boy Scout Troop or Venture Crew, and
have the basic skills required for swimming, rowing, canoeing and lifesaving. This is a dual-certification class, with
participates also completing requirements for Red Cross Lifeguard. The combined class will require about 35 hours
to complete.
When?
Course begins Thursday June 2 with check-in at 4 pm. Class will begin at 5:30. Please make sure you have eaten
dinner prior to class beginning. Course continues with morning, afternoon and evening sessions through Sunday
afternoon.
Where?
Will Rogers Scout Reservation is located about 6.5 miles west of Cleveland, OK on the north side of Highway 64.
From Highway 412, exit Cimarron Turnpike at Hallett, OK and proceed north on Highway 99. Will Rogers SR is
about 1 mile east of junction of Highway 99 and Highway 64.
Cost?
$115 course fee includes all program supplies, Red Cross Lifeguard Fee, BSA Lifeguard patch, CPR mask and a
lifeguard whistle. It also includes all meals from Friday Breakfast through Sunday Lunch . There is an additional
$18 fee to register non-scouts for insurance purposes.
Registration?
Complete and return registration form to Council Office by Monday, May 23
Registration received after May 23 is
$140. Campers must submit at check-in a copy of Parts A, B & C of the Annual Health and Medical Record that
includes a pre-participation physical. Forms can be downloaded from-
What to Bring?
Participants will be sleeping on cots in canvas tents set up on cement platforms. Remember to bring:
___Swim Suit
___Rain Gear
___Sunscreen
___Sleeping Bag/Bedroll
___Pillow
___Personal Toiletries
___Wash Cloth/Towel
___Water Shoes
___Pen or Pencil
___Flashlight
___Deck Shoes
___Water Bottle
 
More Info? Contact Cimarron Council at council@cimarronbsa.org or (580)234‐3652. 
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BSA/Red Cross Lifeguard Mini-Camp
Return Form and Fees to: Cimarron Council, BSA
June 2-5 2016 (Will Rogers SR)
P.O. Box 3146, Enid, OK 73702
Name:__________________________________________ Age: ______________________
BSA Troop/Team/Crew/Post (circle one)______________ # Gender: Male Female
Address: City: Zip: _________________________________________________________
Mobile Phone:____________________ Home/Work Phone ______________________________
E-mail ______________________________________________________
EMERGENCY CONTACT (Parent/Spouse/etc. not attending with participant):
Name: ____________________________Relationship: ____________________________________
Mobile Phone__________________________: Home/Work Phone _________________________________
Payment Amount: $_____________
Check (Payable to Cimarron Council, BSA) Number: ___________________
Credit Card: Visa Mastercard (Circle one)
Card #__ __ __ __- __ __ __ __- __ __ __ __- __ __ __ __ Expiration Date ______/______
Signature _______________________________________________________________ 

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