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Personal Information
 

Health / Consent Information
 

*Phone 1:

Phone 2:

Check all that apply:

Asthma :

Any conditions that require care:

Special Medication:

Tetanus Year:

DIGITAL CONSENT:

In case of an emergency, I understand every effort will be made to contact me (if an adult, my spouse or next in kin.) In the event I cannot be reached, I herby give my permission to the physician selected by the adult leader in charge to secure proper treatment, including hospitalization, anesthesia, surgery, or injections of medication for my child/myself.

*Adult Consenting:

 

Membership Information
 

*OA Honor
Ordeal Brotherhood Vigil

*Lodge
--Lodge not listed-- W4-B: Wiatava 13 W4-B: Cahuilla 127 W4-B: Navajo 98 W4-B: Tiwahe 45

*Chapter
--Out of Section-- W4-B#13: TaTanka W4-B#13: Tenaja W4-B#13: Ahwahnee W4-B#13: Santee W4-B#13: Crow W4-B#13: Modoc W4-B#13: Koshare W4-B#13: Amimi W4-B#13: Anasazi W4-B#13: Maga Taskozu W-4B#127: Aca W-4B#127: A-tsa W-4B#127: Hutuk W-4B#127: Mojave W-4B#127: Tahquitz W-4B#127: Serrano W-4B#127: Soboba W-4B#127: Wanakik W-4B#127: Wisumahi W-4B#127: Yamiwa W-4B#45: Allohak W-4B#45: Bitani W-4B#45: Elauwit W-4B#45: Hadaazli-To W-4B#45: Kah-Shinni W-4B#45: Naabaahii W-4B#45: Pischk W-4B#45: Shash-Tsoh W-4B#45: Wulinaxin W-4B#98: Kinaani W-4B#98: Tseyikehe W-4B#98: Kaa' Diné W-4B#98: Atsosi Diné

Lodge Not Listed

*Youth/Adult
Y A

Training Information
 

CIA: College of Indian Affairs
CLP: College of Leadership and Program
CNA: College of New Arrowmen
COA: College of Outdoor Adventure
CGS: College of General Studies
COP: College of Professorship (Must be pre-approved)

Click Here for a Description of the Courses
Session 1:
OPEN-A Dutch Oven Cooking (Session A & B) Bonnet Design and Strategy (Session A & B) The Fundamentals of Beadwork (Session A & B) The Where to Go Camping Guide Philmont Trek Preparation Safe Scouting Starts With Leadership All About OA Unit Representatives Chapter Assistance Program Dynamics of Leadership The Building of a Lodge Fellowship Bicycling in Style Acquiring the Service Vision Cub Scout Ceremonies and Involvement Ceremony Team Coaching I'm Ordeal -- Now What? History and Purposes of the OA Arrowmen 101 Conducting a Scouts Own Ceremony Props and Costumes Staging the Ceremony Introduction to Pow Wow Drumming

By submitting your registration information, you indicate that you agree to the Terms and Conditions and have read and understand the Code of Conduct. Your submission of this form will constitute your consent to the collection and use of your personal information and the transfer of this information to the Conference Management and or other adult officials for processing. All information provided by means of your online registration will remain private and privileged to only adult advisors affiliated with the Section Council of Chiefs. Lastly by submitting your registration information you agree to receive required administrative and promotional information electronically.

Click Submit to go to the Confirmation Page
If you experience problems with the submission, please contact Brandin Grams