Application For Bsa Lifeguard

COUNCIL RECORD

Is counselor certified? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

A P P L I C ATION FOR

Is applicant registered? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

B S A

A P P R O VA L :

C e r t i f i c ate written _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

L I F EGUA R D

Filed for year-end report _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

This fo rm to be used in local council only

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ , registered in _ _ _ _ _ _ _ _ _N o . _ _ _ _ _ _ _ _ _ o f _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _,

Name

Unit

City or Town

who lives at _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ , _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ , _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ,

Street or R.F.D.Address

City or Town

State

Zip Code

has satisfactorily completed all requirements for BSA Lifeguard. D ate of completion _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Certifying Counselor’s Signature

Type of Certification

Expiration Date

Instructing Counselor’s Signature

Type of Certification

Expiration Date

Instructing Counselor’s Signature

Type of Certification

Expiration Date

BSA LIFEGUARD TRAINING PRO C E D U R E

1 . Only those persons currently certified as BSA A q u atics Instructor or as

4 . The completed ap p l i c ation is sent to the local council service center where

BSA Lifeguard Counselor may train the completion of BSA Lifeguard

BSA Lifeguard emblems may be purchased.

r e q u i r e m e n t s .

5 . To qualify for BSA Lifeguard, the candidate must complete the BSA

2 . Training as BSA Lifeguard is valid for 3 years from the date of ap p l i c at i o n .

Lifeguard course consisting of a minimum of 30 hours under the direction

3 . All requirements must be met—no substitutions or omissions are permitted.

of either a BSA Lifeguard Counselor or a BSA A q u atics Instructor. T h e

course for the BSA Lifeguard is in the BSA Lifeguard Counselor Guide.

BSA LIFEGUARD R E T R A I N I N G

To be retrained as BSA Lifeguard, a person who previously has been trained

the past 12 months can be retrained by demonstrating a current knowledge of

can complete the regular BSA Lifeguard course, passing each of the require-

and ability to perform the skills necessary to fulfill BSA Lifeguard require-

m e n t s . Those whose BSA Lifeguard training is current or has expired within

m e n t s . It is not necessary to retake the BSA Lifeguard course.

C O U N S E L O R S ’R E S P O N S I B I L I T Y

S c o u t s , Ve n t u r e r s , or adults who become trained BSA Lifeguards must be well

The reputation of the counselors as experts depends to a great extent on the

qualified and able to use their knowledge in case of need without undue dan-

actual performance of those they qualify. T h e r e f o r e , they should be certain

ger to themselves and with a reasonable chance of success. The counselors

t h at the candidates’ ability is, without doubt, of the highest caliber. It is expect-

are responsible for the strict interpretation of requirements and the eliminat i o n

ed that the BSA Lifeguard emblem and certificate will always stand for a very

of applicants who in their judgment are not qualified by strength, j u d g m e n t , o r

high standard of skill. The counselors to whom this responsibility is entrusted

ability to put their knowledge into practice.

are expected to maintain that standard. For interpretation of requirements, s e e

BSA Lifeguard Counselor Guide, N o .3 4 5 3 6 A .

Counselor’s

Counselor’s

BSA LIFEGUARD REQU I R E M E N T S

D a t e

I n i t i a l s

D a t e

I n i t i a l s

1 . AGE REQU I R E M E N T

consist of a minimum of 50 yards of elementary

backstroke; 50 yards of breaststroke; 50 ya r d s

To enroll in the BSA Lifeguard course you must be

of front crawl or trudgen; and 50 yards of

at least 14 years of age or have completed the eighth

s i d e s t r o k e .

_ _ _ _ _ _

_ _ _ _ _ _ _ _

g r a d e .

_ _ _ _ _ _

_ _ _ _ _ _ _ _

( b ) Surface dive. Perform a feetfirst and a tuck or pike

2 . P R E R E QU I S I T E S

surface dive in 8 to 10 feet of water and recover

To enroll in the BSA Lifeguard course, you must

a 10-pound weight on both dives.

_ _ _ _ _ _

_ _ _ _ _ _ _ _

( a ) Swim 400 ya r d s . Jump feetfirst into wat e r

( c ) F l o at .D e m o n s t r ate the ability to rest by float i n g . _ _ _ _ _ _

_ _ _ _ _ _ _ _

over your head and swim continuously for 400

( d ) D i v e . Perform a long, s h a l l ow dive.

_ _ _ _ _ _

_ _ _ _ _ _ _ _

yards in a strong manner. The 400 yards shall