Republic of the Philippines

Department of Education
Region VII, Central Visayas
Division of Cebu Province
TAYUD NATIONAL HIGH SCHOOL
Tayud, Consolacion, Cebu

BOY SCOUTS OF THE PHILIPPINES (BSP) DIVISION
SENIOR SCOUTS VENTURE CAMP
December 11-13, 2015
Venue: Living Hope Christian Academy Incorporated, Old BTC Campus
Banal Poblacion, San Remigio, Cebu
Theme: Peace and Development Through Scouting

PERSONAL INFORMATION
NAME: ____________________________________________________________________________
Family Name Given Name Middle Name
PRESENT ADDRESS: __________________________________________________________________
EMAIL ADDRESS: _________________________ CONTACT NUMBERS: _________________________
In case of emergency please notify ____________________________- _________________________
Complete Name Relationship to Participant
CONTACT NUMBERS: ________________________________________________________________________________

PARENT’S / GUARDIAN’S CONSENT

I understand that the participation in Scouting activities involves a certain degree of risk and can
be physically, mentally, and emotionally demanding. I have carefully considered the risk involved and
have given consent for myself or my child to participate in this activity. I also understand that
participation in this activity is entirely voluntary and requires participants to abide by applicable rules
and regulations and standards of conduct. I release the Boy Scouts of the Philippines, the Local Council,
the activity coordinators, and all professional staff, volunteers, related parties, or other organizations
associated with the activity from any and all claims or liability arising out of this participation.

In case of emergency involving my child, I understand that every effort will be made to contact
me. In the event that I cannot be reached, I hereby give my permission to the medical provider selected
by the adult leader in charge to secure proper treatment, including hospitalization, anesthesia, surgery,
or injections of medication for my child. Medical providers are authorized to disclose to the adult in
charge examination findings, test results, and treatment provided for purposes of medical evaluation of
the participant, follow-up and communication with the participant’s parents or guardian, and/or
determination of the participant’s ability to continue in the program activities.

___________________________________________________
SIGNATURE OVER PRINTED NAME OF PARENT/ GUARDIAN
DATE: _____________________
VERIFIED BY:

LOUIE ADRIAN M. TANUCAN GENEVIVE I. JUDAYA
Outfit Advisor Outfit Advisor

JENNIFER B. CASAS
TAYUD NHS- PRINCIPAL

00 for the food and other incidental fees for three days LIST OF MAJOR ACTIVITIES 1. Clothes a. Pair of slippers and rubber shoes d. 1 bundle of firewood C. Pioneering Project 9. Scouting Materials a. Kitchen a. 1 meter abaca rope F. Camp Inspection 5. Sleeping Gears a. Toilet paper D. Scouting Uniform Type A or khaki pants. Effects of Prohibited / Illegal Drugs (CPADAC) 7. lunch box. water bottle / water jug (I liter) b. Grand Campfire 10. towel c. Soap and shampoo b. Brief or boxer shorts B.As Self Defense (Private Institution/ NGO) 8. Medication G. Things to bring (INDIVIDUAL) A. Fancy Drill Competition 6.Best in Camp Lay-out 2. 250. Carton for bed E. Lecture Forum on a. Personal Hygiene a. cup. Spoon. Community Service 12.) c. Toothpaste and toothbrush d. Disaster Preparedness and Response (Provincial DRRMO) b. Blanket b. Search --. socks e. fork. Snacks (biscuits. BSP Got Talent 4. Lecture/ Demo Skills on Basics of Martial Arts. Scouting notebook c. white shirt with belt b. Shorts and t-shirts f. Neckerchief c. etc. 2 packs noodles and 1 canned goods d. Flashlight b. Obstacle Course . Rally Games 11. Balak and Harana Contest 3.

Electrical wires. 3 dippers B. Knife (school and Clarence) f. Hammer (Andrei) . Bond papers c. Trapal and ropes (Louie Tanucan) q. Chopping board (ronel) g. Scouters directory C. 1 big drum t. Rice cooker (Louie Tanucan) n. Folders d. 3 pales u. Things to Bring (Outfit) A. Lighter (Louie Tanucan) i. Poles (scouters) r. Portable speakers D. electrical tape E. Trash bags (Louie Tanucan) s. Sundang F. 3 empty water bottle (5 liter bottle) (school. Ballpen/ pencil/ marker b. Sug-angan d. Bara (Mam Genevive) H. Butane Stove (Devone) b. Water Dispenser (School) o. Jaylord) k. Stationary a. Luwag (john Romar) h. Sealed envelope for pertinent documents e. Gabas G. Bbq screen (Jay Judaya) e. Kaha l. Dishwashing Soap (Louie Tanucan) j. 2 chairs and 1 table (school) p. Kitchen a. Miss Judaya. Firewood (individual scout) c. extension wires. Kaldero (school) m.