Cabrillo Beach Youth
Waterfront Sports Center
All fields are required.
Name: Street Address: City: State: Zip Code: Phone (with area code): Email address: Age: None 10 11 12 13 14 15 16 17 Troop: Council:
None Rank Advancement--Safety Afloat and Safe Swim Defense Swimming--Periods 1 and 2 Lifesaving--Periods 1 and 2 Rank Advancement--First Aid, Heart Attack signs and symptoms, Heimlich maneuver Canoeing--Periods 1, 2 and 3 Art ($5 materials fee) Leatherwork
None Rank Advancement--Water rescue methods, BSA swim test, tender/rescuer methods Rank Advancement--Safe hiking rules, raise/fold flag, buddy system, constitutional rights. Music Rowing
None Rank Advancement--First Aid, Heart Attack signs and symptoms, Heimlich maneuver Swimming--Periods 3 and 4 Lifesaving--Periods 3 and 4 Rank Advancement--Safety Afloat and Safe Swim Defense Music Wood Carving
None Rank Advancement--Safe hiking rules, raise/fold flag, buddy system, constitutional rights. Rank Advancement--Water rescue methods, BSA swim test, tender/rescuer methods Family Life Art ($5 material fee) Reading
Guardian/Emergency InformationParent/Guardian Name: Home Phone with Area Code: Work/Cell Phone with Area Code:
Emergency Contact Name: Relationship: Home Phone with Area Code: Work/Cell Phone with Area Code:
Does the participant have a history of or currently have any physical limitations that might prevent him/her from fully participating in any classes? Yes NoIf yes, please describe below. If none, state "NONE"
Please list any special medications, allergies to food or drugs or any other pertinent medical information. If none, state "NONE"
Dr. Fisher
Cabrillo Beach Youth
