BOY SCOUTS OF THE PHILIPPINES

Ramon Magsaysay (Zambales) Council

2/F Estrada Bldg. Baytan, Zone 6, Iba, Zambales Philippines
Mobile No. 0918.422.07.03/Email: bspzambales1947@gmail.com
BSP-RMC is committed to gender equality, in its mandate and its members.

Activity : 37TH PROVINCIAL SCOUT JAMBOREE

Venue : JOSE A. GARCIA SR. PROPERTY, Brgy. Burgos/Angeles, San Antonio, Zambales
Date : May 23- 27, 2023

Name: Nickname:
Mailing Address: Cell No.
Date of Birth: Place of Birth: _________________________________
Age: ____________________ Religion: __________________________________________________________________
BSP Card No: ____________________________________Valid Until: __________________________________________
Sponsoring Institution: _______________________________________________________________________________
Address: _______________________________________________ Cell No: ____________________________________

On my Honor, I promised to cooperate with the Leaders and comply with all the requirements as prescribed by the Boy
Scouts of the Philippines.

________________________________________ _______________________________
Signature of Applicant Above Printed Name Date

PARENTS/GUARDIAN’S APPROVAL

This is to inform you that having considered the benefits my son/daughter/ward, named above, will derive from his
participation in the above named activity, I approved his/her participation with the understanding that every precaution
will be taken by the Scout Leader and the members of the staff concerned to insure his safety during the activity.
Furthermore, I will not hold any of the Scout Leaders responsible for any untoward incident beyond their control that
may happen to him or his belongings.

__________________________________________ _________________________________
Signature Over Printed Name Home Address

MEDICAL CERTIFICATION
I hereby certify that I have examined the above Scout and have found him/her physically fit to attend the above activity.

__________________________________________ _________________________________
Signature of Physician Date

License No. ________________________________

RECOMMENDING APPROVAL:

__________________________________________ ___________________________________
Institutional Head/ Scout Coordinator Unit Leader