BSA Fourth of July Questionnaire

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* 1. First Name

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* 2. Last Name

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* 3. Who's your mentor?

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* 4. Emergency Contact Name:

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* 5. Emergency Contact Number:

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* 6. Emergency Contact Relationship:

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* 7. Final Head Count:

We appreciate that many local families will celebrate the 4th of July this weekend. Please consider the following:
- July 4th: ALL BSA scholars and staff will travel as a community to a local amusement park.
- July 5th: Scholars will resume their regular BSA class schedule.
-Scholars are permitted to depart BSA for the weekend beginning at 6:00 pm on Friday, July 5th up until 11:00 am on Saturday, July 6th only. Scholars must return on Sunday, July 7, by 8 pm latest.
-Scholars who remain on campus will be required to attend Saturday's activity.
Please indicate whether or not you will leave for this July 5th weekend.

I WILL depart between 6:00 pm on Friday, July 5th and 11:00 am on Saturday, July 6th

I WILL NOT depart BSA for the July 5 weekend.

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* 8. Questions/Feedback: