Annual Family Survey | Pack 62

1

Your Scout

Tell us a bit about the scout in your household

Scout's Full Name *

Den / Rank

Years in Pack 62

2

Parent / Guardian Info

How to reach your family throughout the year

Primary Parent / Guardian Name *

Email *

Phone

Secondary Parent / Guardian Name

Secondary Email

Best way to reach you

Email Text Phone call Any

3

What You Hope to Gain

Help us understand what matters most to your family

Select everything that resonates — there are no wrong answers.

Anything else you're hoping for this year?

4

How You Can Contribute

Your time, skills, and resources — even small contributions add up

PACK 62 FAMILY EXPECTATIONS

Every family is expected to:

Contribute at least 24 hours of volunteer service to the Pack per program year
Lead or co-lead at least one den activity per program year
Join at least one Pack community event (parade, service project, fundraiser, or similar)

The questions below help us match your hours, skills, and resources to the right opportunities. A buy-out and a hardship waiver are available for families who cannot meet the hours commitment in a given year.

Hours per month you can realistically give

Occupation (optional)

Job Title (optional)

Hobbies, talents, or skills you could share (optional)

Leadership role you would consider (optional)

With kids, alongside another adult Behind the scenes, supporting other leaders Administrative Not at this time

5

Background & Experience

Helps us connect families with shared backgrounds and tailor our programming

Religious Affiliation (optional)

Scouting experience in your family

Select everyone in your household who has been a scout or scout leader

I was a Cub Scout I was a Boy Scout / BSA Scouts I was a Girl Scout Co-parent / partner was a scout I was a den or pack leader My sibling was a scout My parent was a scout No scouting experience in our family

6

Your Family

A little context helps us serve the whole community better

Neighborhood or subdivision

Number of scout-age children in your household

Do you have children who may join in a future year?

Yes No Maybe

How satisfied are you with Pack 62 so far?

Very satisfied Satisfied Neutral Could be better This is our first year

What's one thing we could do better or add to our programming?

Any other comments or feedback?

7

Required Family Acknowledgments

Always collected, including for anonymous submissions. All fields required.

These acknowledgments are required for participation and recharter per BSA Rules & Regulations and Pack 62 Operating Procedures. Please read each item before checking or selecting.

I acknowledge that a current BSA Annual Health and Medical Record (AHMR) (Parts A and B at minimum; Part C for events 72 hours or longer) is required for each registered Scout in my family and that I will provide and update the form as needed.

Forms are stored confidentially by the Health and Safety Officer per Pack 62 Operating Procedures.

Pack 62 Photo Release. Pack 62, its committee, and adult leaders may use images, photographs, and videos (hard copy or electronic) of consenting persons in Pack-published materials, including the Pack website, Pack-maintained social media accounts (Facebook, Instagram), newspapers, and other publications or promotional materials. Pack 62 does not publish a Scout's full name in any of its own publications. This consent is valid for one (1) year from the date of submission and may be revoked at any time by written notice to the Committee.

OPT IN — I give permission for all uses above OPT OUT — Do not publish images of my family

Names of children covered by this release

Pack 62 Photo Release Form. Per Pack 62 Operating Procedures and BSA Rules & Regulations. Blank PDF available at the top of this page.

I acknowledge that all Pack-sponsored activities comply with the BSA Guide to Safe Scouting, including two-deep leadership, BALOO certification for overnight events, Safe Swim Defense and Safety Afloat for water activities, qualified instructors for shooting sports at council-approved facilities, and council activity approvals. I will follow Pack instructions regarding activity-specific safety requirements.

Per Pack 62 Operating Procedures and BSA Rules & Regulations.

Activity Consent, Medical Authorization, and Release. I understand that participation in Scouting activities involves the risk of personal injury, including death, due to the physical, mental, and emotional challenges in the activities offered. Participation is voluntary and requires participants to follow instructions and abide by all applicable rules and standards of conduct.

In case of an emergency involving my Scout, I understand that efforts will be made to contact me. In the event I cannot be reached, I authorize the medical provider to secure proper treatment, including hospitalization, anesthesia, surgery, or injections of medication. Medical providers are authorized to disclose protected health information to the adult in charge and any physician or health care provider involved in providing medical care.

With appreciation of the dangers and risks associated with programs and activities, including preparations for and transportation to and from the activity, on my own behalf and on behalf of my Scout, I fully and completely release and waive any and all claims for personal injury, death, or loss that may arise against the Boy Scouts of America, the local council, the activity coordinators, and all employees, volunteers, related parties, or other organizations associated with any program or activity.

I acknowledge and agree to the activity consent, emergency medical authorization, and release above for all Pack 62 activities for the current program year.

Participant restrictions, if any

BSA Activity Consent Form (680-673) used as an annual blanket consent. The Pack may use an event-specific form for high-adventure, off-site, or overnight trips when required. Blank PDF available at the top of this page.

I acknowledge I have read and agree to the Pack 62 Family Conduct and Coordination Policy, including the conduct expectations at Pack events, the prohibition on alcohol, controlled substances, and tobacco at Pack events, transportation requirements for drivers of Scouts, and the photo and image release I have selected above.

Pack 62 Family Conduct and Coordination Policy. Per Pack 62 Operating Procedures. Blank policy available for download at the top of this page.

Tell Us About
Your Family

✓ Thank you — your survey is submitted!