Adventurous Activity Permits

Application Type

Is this a new application or a renewal?*

New application
Renewal

Section A - Personal Details

Name*

First Last

Scout Membership Number

For Adult members only

Date of Brith*

Email*

Enter Email Confirm Email

Phone*

Do you have any health factors that may affect the activity?*

Yes
No

This will be dealt with in the strictest of confidence

Health Factors

Things that may affect the activity

County*

District*

Section B - Activity Details

Activity Permit Applying For (from FS120100)*

https://cms.scouts.org.uk/media/11969/activity-permit-list-jan-2019.pdf

Level*

Personal
Leadership
Supervisory

Any restrictions wanted?*

Yes
No

Restrictions

e.g. site/route specific, group sizes, geographical, conditions etc

Section C - Renewal details

If you are applying for a permit exactly the same as one you currently have, or as one that has just expired, please give details here. You will be required to show proof of this permit when you meet with the assessor.

Current Activity Permit (from FS120100)*

https://cms.scouts.org.uk/media/11969/activity-permit-list-jan-2019.pdf

Current Level*

Personal
Leadership
Supervisory

Did you have any restrictions?*

Yes
No

Restrictions

e.g. site/route specific, group sizes, geographical, conditions etc

Section D - Qualification Details

If you have any relevant activity specific qualifications (such as National Governing Body Awards), please give details here. You will be required to show proof of these qualifications when you meet with the assessor.

List

Qualification	Awarding Body	Date Gained

Section E - Logged Experience

Please attach details of all recent logged experience. If you have your own log that you keep please feel free to attach it in its current format. If not you can find generic activity log sheets on the Scout website.

Upload a logbook

Drop files here or

Max. file size: 10 MB.

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