PRE-CAMP SWIM CHECK ADMINISTRATOR

Applicants for Pre-Camp Swim Classification Administrator must be 21 years of age or older.

Name(Required)

First Last

PHONE(Required)

E-MAIL(Required)

DATE OF BIRTH(Required)

Must be over 21 years of age.

SCOUT UNIT NUMBER

DISTRICT

CERTIFICATION

UPLOAD CERTIFICATION

Drop files here or

Accepted file types: pdf, jpeg, png, bmp, jpeg, doc, tiff, Max. file size: 20 MB.

DO YOU HAVE CPR/AED TRAINING?

UPLOAD CERTIFICATION

Drop files here or

Accepted file types: pdf, jpeg, png, bmp, jpeg, doc, tiff, Max. file size: 20 MB, Max. files: 5.

YOUTH PROTECTION TRAINING DATE

AQUATICS EXPERIENCE AND BACKGROUND

OTHER CREDENTIALS

BSA Paddle Craft Safety

Scuba

Swimming and Water Rescue

ARC Instructor

Other

ARE YOU WILLING TO ADMINSTER SWIM CHECKS FOR OTHER UNITS?(Required)

WOULD YOU BE INTERESTED IN SUPPORTING AQUATICS ACTIVITIES AT OUR MCC CAMPS?(Required)

Address(Required)

Address City State Zip Code

SIGNATURE(Required)

TODAY' DATE(Required)