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BOY SCOUTS OF AMERICA
LOCAL TOUR PERMIT APPLICATION
FOR TRIPS AND CAMPS UNDER 500 MILES

LOCAL PERMIT NO.  	  DATE ISSUED  	

This application must be filed with local council service center 2 weeks in advance of scheduled activity for proper clearance.  It is used for trips of less than 500 miles or more one way our outside the U.S.A. (local council | camp excepted) use National Tour Permit Application No. 4419A.  If backcountry trip be sure to know BSA Wilderness Use Policy.

 	 No.  	 Town  	 District  	 hereby applies
	Type of Unit
for a permit and submits plans herewith for a trip from 	 19 	 to 	 19 	
	Date	Date
Give itinerary if tour; or destination if camp, including route description for reaching campsite (for long trip attach map indication route and overnight stops.):

Type of trip: [ ] One day  [ ] Touring camp  [ ] Short-term camp  [ ] Long-term camp (Furnish copy of program and menus.)
Will there be aquatic activities?  	 Does adult (21+) leader have Safe Swim Defense certification?  	
Name of person in group with current water safety certification  	 Age  	 Type of Certification  	
If boating activities are planned, we will use Safety Afloat, No 7368  	
Mode of transportation:  [ ] Car  [ ] Rv  [ ] Van  [ ] Bus  [ ] Boat  [ ] Canoe  [ ] Train  [ ] Hiking  [ ] Truck  Other  	
(The beds of trucks and camper trucks are approved for equipment only--passengers are allowed only in the cab.)
Tour will include  	 youth and  	 adults.  Have parent's approvals been secured.  	
It is the tour leader's and unit committee member's understanding that all drivers, vehicles, and insurance coverages will meet the national requirements as listed on the reverse side of this application.  The Boy Scouts of America policy requires two adult leaders on all camping trips and tours.  Tour leader in charge must be at least 21 years of age.
Tour leader's name  	 Age  	 Phone  	
	Print or Type
Address  	
Assistant leader's name  	 Age  	 Phone  	
			
	Signed by member of unit committee	Signed by tour leader
RETAIN IN COUNCIL SERVICE CENTER
COMPLETE AND RETURN TO UNIT

OFFICIAL LOCAL TOUR OR 
CAMP PERMIT   BOY SCOUTS OF AMERICA

This permit should be in the possession of group leader at all times and displayed when requested by scouting officials or other duly authorized persons.

Permit issued to  	 No.  	 Town  	
	Type of unit
			
	Name of tour leader	Age	Address
			
	Assistant tour leader	Age	Address
Permit covers all travel between  	 and  	
Date of trip from 	 19  	 to  	 19 	
Total youth  	 Total adults  	
The group has given the local council every assurance that they will conduct themselves according to the best standards of Scouting and observe all rules of health, safety, and sanitation as prescribed by the Boy Scouts of America and as stated in the Pledge of Performance on the reverse side of this permit

Local Permit No.  	

Date Issued:  	

Council Stamp

These spaces are for the signatures and comments of officials where the group camps or stays for 1 night or more.  Signatures indicated that the cooperation and conduct of the Cub Scout, Boy Scout, Varsity Scout, or Explorer group were satisfactory in every way. | | Not official unless council stamp appears here.
Date | Place | Signature | Comment | | Council Name and Address
| | | | | Council Phone No.
| | | | | Signed for the Council
9-28-93    lb

INSURANCE
All vehicles MUST be covered by a public damage liability insurance policy.  The amount of this coverage must meet or exceed the insurance requirements of the state in which the vehicle is licensed.  (It is recommended, however, that coverage limits are at least $50,000/$100,000/$50,000.)  Any vehicle carrying ten (10) or more passengers is required to have limits of $100,000/$300,000/$100,000.  In the case of rented vehicles the requirement of coverage limits can be met by combining the limits of personal coverage carried by the driver with coverage carried by the owner of the rented vehicle.  All vehicles used in travel outside the United States must carry a public liability and property damage liability insurance policy that complies with or exceeds the requirements of that country.

KIND | NUMBER | | WILL EVERYONE | PUBLIC LIABILITY INSURANCE COVERAGE
YEAR AND MAKE | OF | OWNER'S NAME | WEAR A | PUBLIC LIABILITY | PROPERTY
OF VEHICLE | PASSENGERS | | SEATBELT? | Each Person | Each Person | DAMAGE
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 
TRANSPORTATION

1.	You will enforce reasonable travel speed in accordance with state and local laws in all motor vehicles
2.	If by motor vehicle
a.	Driver qualifications:  All drivers must have a valid drivers license and be at least 18 years of age.  Explorer exception:  When traveling to an Explorer event under the leadership of an adult (21+) tour leader, an Explorer at least 16 years of age may be a driver subject to the following qualifications:  (1) Six months' driving experience as a licensed driver (time on a learner's permit or equivalent is

not to be counted); (2) no record of accidents or moving violations; (3) parental permission has been granted to leader, driver, and riders.
b.	Drive time is limited to a maximum of 12 hours and must be interrupted by frequent rest, food, and recreation stops.
c.	Seat belts are provided, and must be used, by all passengers and driver. Exceptions:  A school or commercial bus.
d.	Passengers will ride only in the cab if trucks are used.

OUR PLEDGE OF PERFORMANCE

1.	We will use Safe Swim Defense in any water activity.
2.	We will use Trucks only for transporting equipment -- no passengers except in the cab.  All passenger cars, station wagons, recreational vehicles, and cabs of trucks will have a seat belt for each passenger.
3.	We agree to enforce reasonable travel speed (in accordance with national, state and local laws) and use only vehicles that are in safe mechanical condition.
4.	We will be certain that fires are attended at all times.
5.	WE will apply for a fire permit from local authorities in all areas where it is required.
6.	We will at all times be a credit to the Boy Scouts of America and will not tolerate rowdyism or un-Scoutlike conduct, keeping a constant check on all members of our group.
7.	We will maintain high standards of personal cleanliness and orderliness and will operate a clean and sanitary camp, leaving it in a better condition than we found it.
8.	We will not litter or bury trash, garbage or tin cans.  All rubbish that cannot be burned will be placed in a tote-litter bag and taken to the nearest recognized trash disposal or all the way home,  if necessary.

9.	We will not deface trees, restrooms, or other objects with initials or writing.
10.	We will respect the property of others and will not trespass.
11.	We will not cut standing trees or shrubs without specific permission from the landowner or manager.
12.	We will collect only souvenirs that are gifts to us or that we purchase.
13.	We will pay our own way and not expect concessions or entertainment from any individual or group.
14.	WE will provide every member of our party an opportunity to attend religious services on the Sabbath.
15.	WE will observe the courtesy to write thank-you notes to persons who assisted us on our trip.
16.	WE will, in case of backcountry expedition, read and abide by the Wilderness Use Policy of the BSA.
17.	We will notify, in case of serious trouble, our local council service center, our parents, or other local contact.
18.	If more than one vehicle is used to transport our group, we will establish rendezvous points at the start of each day and not attempt to have drivers closely follow the group vehicle in the front of them.