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Colonial District OA Chapter Spring Ordeal May 19th -- May 21st, 1998 Ft. Belvoir, Virginia |
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By May 5th mail
this completed form with your check to:
Order of the Arrow (Colonial
District)
National Capital Area Council
9190 Rockville Pike
Bethesda MD 20814
Please print
all information; use one form per individual; each participant must have a
completed form; copy as necessary.
Name: |
Age: |
Phone: |
Chapter: |
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Address: |
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Unit
Type: Troop/Crew/District |
Unit
Number: |
Date
of Birth (mm/dd/yy): |
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1.
PARENTAL AUTHORIZATION FOR
ALL SCOUTS UNDER 18 YEARS OF AGE
I,
____________________________, parent/guardian of the above named minor, in
the event of illness occurring during his participation at Ft. Belvoir from
19-21 May 2000, do hereby consent in advance to whatever medical procedure or
treatment is considered necessary in the best judgement of the attending
physician. I understand that, in the
event of serious illness or injury that is not an emergency, reasonable
efforts to reach me will be attempted. |
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Date: |
Parent/Guardian
Signature: |
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Phone: |
Address: |
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2.
MEDICAL INFORMATION
Physical
limitations |
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Medical Conditions requiring medications |
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Medication |
Dosage |
Frequency |
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Special
dietary needs: |
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Medical
Insurance Company: |
Policy
No.: |
Group
No.: |
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3.
EMERGENCY NOTIFICATION
INFORMATION
Name: |
Relationship: |
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Address: |
Phone
No. 1 |
Phone
No. 2 |
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4.
REGISTRATION FEES ARE AS
FOLLOWS
Make
checks payable to: BSA/NCAC
-- (Colonial District OA Chapter)
Member |
$18.00 |
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Covers
food and fees. |
Brotherhood
Conversion |
$30.00 |
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Covers
food, fees, and Brotherhood sash. |
Ordeal
Candidate |
$35.00 |
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Covers
food, fees, membership dues, sash, and handbook. |
Elangomat |
$13.00 |
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Covers
food and fees (includes a discount for cheerful service). |
Saturday
only |
$11.00 |
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Covers
food and fees for one day only. |
Membership
Dues |
$7.00 |
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Current
"members" who have not yet paid their 2000 dues. |
Total
Amount Enclosed |
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5.
SIGNATURE IF OVER 18 YEARS
OF AGE
NAME: |
DATE |
6.
HAVE QUESTIONS? Contact Dominick Caridi at 703-360-9206 or
dscaridi@aol.com
Directions
to the Fort Belvoir Scout Area
FROM POINTS NORTH
Heading south on the George
Washington Parkway. Continue on the GW
Parkway past all the bridges, past Regan National Airport and through Old
Town. Going this way has you by-passing
all the usual traffic problems. No
malls, no mixing bowl, no Wilson bridge back up, no Route 1 traffic -- no
nothin'!
Continue South on the GW
Pkwy. At the traffic circle in front of
Mount Vernon bear right into the Route 235 North - Route 235 South fork. Take the Route 235 South (left) fork. Continue on Route 235 South to US Route
1. The landmarks at this corner are a
horse farm on the SE corner, Woodlawn Plantation on the SW corner, a Roy Rogers
at the NW corner, and a gas station at the NE corner.
Turn left onto to US Route
1. At the first light, Woodlawn Road,
turn right. Continue to the first
light, Gorgas Road, turn left there.
Follow Gorgas Road to Stonewall Jackson. Take a left at Stonewall Jackson. Stop at the pavilion on your left.
FROM POINTS WEST
Take the Fairfax County
Parkway past the point at which it turns into the Springfield-Franconia
Connector to Beulah Street (this is just below Springfield Mall and at the
Manchester Lakes strip mall).
Turn right onto Beulah. Proceed on Beulah Street as it turns into
Woodlawn Road. Proceed on Woodlawn Road
to Gorgas Road, turn right there.
Follow Gorgas Road to Stonewall Jackson. Take a left at Stonewall Jackson. Stop at the pavilion on your left.
FROM POINTS SOUTH
Take US Route 1 past the
main entrance to Fort Belvoir to Woodlawn Road. At Woodlawn Road, turn left.
Continue to the first light, Gorgas Road, turn left there. Follow Gorgas Road to Stonewall Jackson. Take a left at Stonewall Jackson. Stop at the pavilion on your left.