Child's name:
*
First Name
Last Name
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Cell
School
Church
I have been an Adventurer:
*
No
Yes
My parents are Master Guides:
*
Father:
No
Yes
Check level(s) you are invested in:
Little Lamb
Eager Beaver
Busy Bee
Sunbeam
Builder
Helping Hand
Father's Signature & Email Address
*
Mother's Signature & Email Address
*
Guardian's Signature & Email Address
(If applicable)
Adventurer Uniform
*
Field Uniform - Club T-Shirt
I have
I need
Adventurer Uniform
*
Left Arm:
I have a Gulf States Conference Patch
I need a Gulf States Conference Patch
I have a Adventurer World Insignia
I need a Adventurer World Insignia
Adventurer Uniform
*
Right Arm:
I have a Club Crest Insignia
I need a Club Crest Insignia
I have an insignia patch
I need an insignia patch
Adventurer Uniform
*
Neck:
I have a scarf
I need a scarf
I have a slide
I need a slide
Adventurer Conduct and Participation Agreement
*
1. Adventurers should be on time to all club meetings and events. Chronic tardiness will be taken into account when evaluating an Adventurer's personal performance.
2. Field Uniform (club tee shirt, knee-length shorts or jeans, tennis shoes) will be worn at all club meetings and informal activities and functions unless otherwise specified, including campouts. Open toe shoes are not allowed at club meetings.
3. Complete Class A or B Uniform will be worn at all formal club activities and designated club meetings. Class A uniform consists of: white shirt with all patches and pins, navy blue dress slacks (boys) navy blue jumper (girls), navy blue socks (boys) white socks (girls), black dress shoes (closed toe), sash, scarf, and uniform slide. Class B uniform is all of the above without the sash, scarf and slide.
4. Jewelry: We as members of the Seventh-Day Adventist Church believe that the wearing of jewelry and the display of wealth that it implies is inconsistent with the principles of Adventuring. Therefore we request that no visible jewelry be worn to any Adventurer function. This also prevents the loss of valuable items.
5. Adventurers should attempt to participate in all activities for their class level and maintain good conduct.
6. Adventurers will show respect at all times to the Adventurer Staff, their fellow adventurers, as well as all other people. Adventurers are expected to follow directions of Adventurer staff.
Adventurers will be a “Servant of God” and a “Friend to man” at all times, whether during club meetings or events at home, church, school or in the community.
7. During club meetings or events Adventurers will stay together with a counselor or instructor. If an Adventurer needs to leave the group area they must have permission from a counselor, sign-out as instructed (if applicable), and travel using the buddy system.
8. On campouts, Adventurers are expected to help out with set up, take down, kitchen patrol or any other necessary duties; we must work as a team. Adventurers should not expect to go home until all equipment is cleaned and put away.
9. Adventurers will abide by the Pathfinder’s Camping Code of taking only pictures/memories and leaving only footprints while camping. Remember that nature is God’s first published book.
10. New Adventurers will be put in class levels according to age and grade level. To join the Adventurer Club, a child must be between Pre-K and 4th grade. If a child is moving to the club at any point during the year, they should bring their records from their previous club.
Agreed to by:
(Adventurers name, parent's name, and signature)
ADVENTURER CLUB MEDICAL RECORD/CONSENT FORM
*
FAMILY PHYSICIAN, PHONE, MEDICAL INSURANCE COMPANY,
INSURANCE POLICY NUMBER
ADVENTURER CLUB MEDICAL RECORD/CONSENT FORM
DOES YOUR CHILD HAVE A HISTORY OF ANY OF THE FOLLOWING?
Heart disease
Asthma
High blood pressure
Kidney Disease
Diabetes
Anemia
Immune Deficiency
Shortness of Breath
Cancer
Liver Disease
Hepatitis
Heart Murmur
Seizures/Convulsions
Emotional Disorders
Thyroid Problems
Hyperactivity
Bleeding/Hemophilia
Back Problems
ADVENTURER CLUB MEDICAL RECORD/CONSENT FORM
DOES YOUR CHILD HAVE ANY ALLERGIES? (I.e. food, medications, insect bites, hay fever, etc.)
If Yes, please list :
ADVENTURER CLUB MEDICAL RECORD/CONSENT FORM
HAS YOUR CHILD EVER BEEN HOSPITALIZED? If Yes, when? List the hospitalizations:
ADVENTURER CLUB MEDICAL RECORD/CONSENT FORM
IS THERE ANY REASON TO RESTRICT FULL ACTIVITY, INCLUDING, BUT NOT LIMITED TO SWIMMING,
HIKING, OR STRENUOUS PHYSICAL ACTIVITY?
If Yes, why:
ADVENTURER CLUB MEDICAL RECORD/CONSENT FORM
DOES YOUR CHILD HAVE ANY MEDICAL CONDITIONS NOT COVERED ABOVE? Please list the reasons:
ADVENTURER CLUB MEDICAL RECORD/CONSENT FORM
IS YOUR CHILD TAKING ANY MEDICATIONS AT PRESENT?
(If so, what?)
ADVENTURER CLUB MEDICAL RECORD/CONSENT FORM
I (We) the undersigned parent, parents or legal guardian of
___________________
(Name of Adventurer)
in case of an emergency, I hereby give permission to the physician selected by the club directors to hospitalize, secure proper treatment for, and to order injections, anesthesia or surgery for my child. I understand that every reasonable effort will be made to contact me. The information given by me on this form is correct to the best of my knowledge, and the person herein described has permission to engage in all prescribed activities, except
as noted by me.
(Name, Date, Relation to child)