Leader Renewal for 2023-2024 – 1st Binbrook Scouting Group

Application for Renewal of a Leader Membership
BP Service Association (BPSA) within 1^st Binbrook Scouting

Applicable to the Scouting year starting November 1, 2023 and ending October 31, 2024.

For RENEWALS only. For new members, please contact info@1stBinbrook.org for the correct forms package.

In references to Online Scout Manager below, please use this link to login and validate previously recorded information: Online Scout Manager (click here)

Name of Leader (full legal name as appears on police check)

Date of Birth (YYYY-MM-DD) - (supplied only to use to match up name & DOB with previously supplied police check)

I have logged into the Online Scout Manager system, using the link above, and I have reviewed our previously submitted personal contact information, mailing address, phone numbers, and email addresses, and;

There are no changes

I have logged into Online Scout Manager, and made my edits there.

I have made corrections, and initialed them on the original form on file with the group administrator..

I have sent/attached a new replacement Registration and Contact form (page one), taken from this website.

I have reviewed the previously submitted medical information page, and;

There are no changes

I have logged into Online Scout Manager, and made my edits there.

I have made corrections, and initialed them on the original form on file with the group administrator..

I have sent/attached a new replacement Medical Information form (page two), taken from this website.

Since the last submission of forms, I have completed or renewed training in the following areas;

None

As detailed here:

(include any applicable details, dates, or expiries)

I hereby apply to be renewed as a member in the BP Service Association and to participate fully in all activities.

I hereby agree.

I confirm that I have received a copy of, have read, understand and agree to abide by the Association's Child Protection Policy.

I hereby confirm.

I agree to uphold and abide by the Policy, Organization and Rules (PO&R) of the BP Service Association.

I hereby agree.

I hereby acknowledge that as an adult member I have the responsibility to be a good role model to the youth members of the association. I am accountable for my actions and understand that should the Provincial Council deem my behavior to be inappropriate or in contravention of the Scout Laws, my membership will be cancelled.

I hereby acknowledge.

I release the BP Service Association and its Leaders, Directors and Officers of any responsibility or liability for any injury or damage to person or property whatsoever sustained in connection with its activities.

I hereby release.

I hereby grant the BP Service Association permission to use my image in all publications, both print and electronic, and display on the Association’s websites. I also give permission for the BP Service Association to give this image to a reputable third party, when requested, for both print and electronic publications.

I hereby grant.

I declare, there are no criminal charges pending against me, in Canada or abroad.

I hereby declare.

I declare, I have received no criminal convictions at any time, outside of Canada.

I hereby declare.

I declare, since the last Criminal Background Check collected by the BPSA, or since the last Application Renewal and Declaration given by me to the BPSA, that I have had no convictions under the Criminal Code of Canada up to and including the date of this declaration for which a pardon has not been issued or granted under the Criminal Records Act (Canada).

I hereby declare.

This renewal application and these declarations are made freely, without reservation or intent to conceal any other related facts of any type or detail. By typing my full name below and submitting this form electronically, I agree to be bound by the same terms as a written signature on a parallel paper form. Signed on this date: (YYYY-MM-DD)

Signature (full legal name)

Signed at: (town or municipality)

THANK YOU!

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