SIMON KENTON COUNCIL BOY SCOUTS OF AMERICA 2010 RAPPELLING CLINIC REGISTRATION FORM I wish to register for the following clinic(s): Spring: May 14 – 16, 2010 ________ Fall: September 187- 19, 2010 ________ NAME _____________________________________________ BIRTH DATE ________________ ADDRESS ____________________________________________________________________ CITY ___________________________________ STATE ____________ ZIP ____________ PHONE NO (_______) __________________ OTHER PHONE NO (_______) __________________ EMAIL ADDRESS ________________________________________________________________ COUNCIL _______________________ DISTRICT _____________________ TROOP ____________ *** (Youth under 18) *** Guardian/Parent _______________________________ Guardian/ Parent_______________________________ *** Any youth under the age of 18 must have their parent/guardian signatures in the places designated. My rappelling experience prior to this date is _________________________________________ Number of Simon Kenton Rappelling Clinics attended: None ___ One or More ___ Previous Clinic Participants, last clinic l was: ___ Beginner ___Knots & Rigging ___ Rescue ___ Intern BRING A COPY OF YOUR REGULAR HIGH ADVENTURE PHYSICAL FORM FOR THIS COURSE Attached is my check (payable to the Simon Kenton Council, BSA) for the above registration First time attendees: ($100.00/$80.00*) ________________ Additional clinics: ($65.00/$45.00*) ________________ RappelMasters: ($25.00) ________________ Total ________________ * Early Bird Discount of $20.00 for registration forms received at the BSA Council Office by 5PM May 7 - Spring Clinic or Sept. 10 - Fall Clinic RETURN this form to the Simon Kenton Council office: Rappelling Clinic Registration Simon Kenton Council, B.S.A. 1901 East Dublin-Granville Rd. PO Box 29207 Columbus, Ohio 43229-0207 Or Submit Online through the Simon Kenton Council Website Calendar: www.skcbsa.org RAPPELLING CLINIC FOR ADULT, YOUTH AND TROOP LEADERSHIP SPONSORED BY: SIMON KENTON COUNCIL, RAPPELLING SUB-COMMITTEE WHEN: Spring Clinic: May 14 – 16, 2010 Fall Clinic: September 17 - 19, 2010 Both clinics: 7 p.m. Friday to 3 p.m. Sunday WHAT: Rappelling Clinic – A weekend training clinic combining rappelling skills with fun and fellowship. RappelMaster – An individual who is qualified to lead his/her unit on rappelling outings; a RappelMaster is required for all rappelling tour permits/outings. HOW: To qualify as a RappelMaster, an individual must pass the intern portion of the program. Individual must be able to demonstrate the skills taught in this course. This usually requires 2 to 4 clinics. WHO: Scouts (14 and older), BSA & Non BSA Adults & Troop Leadership WHERE: B.S.A. Camp Falling Rock, Licking County, Ohio WHY: The objectives of the Rappelling Clinic are two-fold: 1) To help young scouts and novices learn safe and proper rappelling techniques. 2) To qualify the more experience participants as RappelMasters. COSTS: First time attendees: $100 This cost includes food, lodging, program materials and equipment. Each first time attendee will receive a locking D-ring, 66 page Rappelling Course manual, 20’ section of webbing, 5’ & 9’ section of prusik line, and a patch. Returning attendees: $65.00/Clinic This cost includes food, lodging, and program materials. DISCOUNT: All attendees can receive $20.00 off with early bird registration. To receive this discount, fee due by close of business (5 p.m.) on the following dates: Spring Clinic- Friday, May 7, 2010 Fall Clinic- Friday, September 10, 2010 REGISTRATION: Rappelling Clinic Registration can be made by returning the accompanying registration form and appropriate fees to: Rappelling Clinic Registration Simon Kenton Council, B.S.A. 1901 East Dublin-Granville Rd. PO Box 29207 Columbus, Ohio 43229-0207 Or Submit Online through the Simon Kenton Council Website Calendar: www.skcbsa.org PACKING: Participants should dress as the weather dictates and wear tight-fitting clothes and a belt. Lodging and bunks will be provided; however, participants will need to supply their own bedding. You may also bring your own tent for housing. |