Member Application "*" indicates required fields Step 1 of 9 11% Membership Application Form The Member Application Form is to be used for individuals seeking to join Scouts Queensland. Once complete, the applicant will receive a PDF version of their form via their nominated email address. Their Group Leader will then be asked to endorse the application for continued processing. If you have any questions about the application, or require support, please contact the Branch Support office via email at helpdesk@scoutsqld.com.au or on 07 3870 7000 during normal business hours. Joining fees Scouts Queensland fees can be found here. Formation DetailsWhat type of member is the applicant?* Youth Member (Joey, Cub Scout, Scout or Venturer under 18 years of age) Adult Member (Leaders, Rovers, Adult Supporters and Fellowship Members) Which Scout Group or Formation is the applicant joining?*Select Group…26th Australian Jamboree Executive team2nd Nambour Scout Group2nd Toowoomba Scout GroupAlbany Creek Scout GroupAlgester Scout GroupAlice River Scout GroupAllawah CampsiteArcher DistrictAshmore Scout GroupAspley Scout GroupAtherton Scout GroupAtkinson DistrictBaddow Scout GroupBaden Powell Park Campsite, Training and Activity CentreBald Hills Scout GroupBanksia Scout GroupBarcaldine Scout GroupBardon Scout GroupBarrabadeen Camp and Activity CentreBartle Frere DistrictBauple Scout GroupBayside Sea Scout GroupBayview Scout GroupBeauaraba DistrictBeaudesert Scout GroupBeaver Masters DistrictBeenleigh Scout GroupBelgian Gardens Scout GroupBelmont Scout GroupBiloela Scout GroupBirkdale Scout GroupBlackwater Scout GroupBluewater Scout GroupBoondall Scout GroupBoyne Tannum Scout GroupBracken Ridge Scout GroupBramble Bay DistrictBranch Support OfficeBranch Support Office – Brand and Sponsorship teamBranch Support Office – DevelopmentBranch Support Office – Facilities and Risk teamBranch Support Office – Finance teamBranch Support Office – IT teamBranch Support Office – Operations TeamBrand and Sponsorship Reference GroupBribie Island Scout GroupBrisbane First Chinese Scout GroupBrisbane Gang ShowBrisbane North RegionBrisbane Parade Scout FellowshipBrisbane South Chinese Scout GroupBrisbane South RegionBroadwater DistrictBrownsea Water Activity CentreBrowns Plains Scout GroupBuddha's Light Scout GroupBuderim Scout GroupBundaberg DistrictBunya DistrictBunya Park Scout GroupBurleigh Heads Scout GroupBurpengary Scout GroupBurrum Scout GroupCaboolture Scout GroupCalliope Scout GroupCaloundra Scout GroupCamira Scout GroupCamp Cooroora Scout FellowshipCanungra Scout GroupCapalaba Scout GroupCapella Scout GroupCapricorn DistrictCentenary-Gympie Scout GroupCentral and Western Queensland RegionCentral Coast RegionCentral West DistrictCharles S Snow DistrictCharleville Scout GroupCharters Towers Scout GroupChermside Burul Scout GroupChilders Scout GroupChinchilla Scout GroupClermont Scout GroupCleveland Scout GroupClifton Hill Scout GroupClifton Scout GroupCloncurry Scout GroupClontarf Beach Scout GroupCoalfields DistrictCoomera Scout GroupCooroy Scout GroupCoral Coast DistrictCraignish Scout GroupCrows Nest Scout GroupCunningham DistrictDAguilar Range DistrictDalby-Yumborra Scout GroupDarling Downs RegionDarling Downs RevueDayboro Scout GroupDeception Bay Scout GroupDiamantina DistrictDolphin Sea Scout GroupDrayton Scout GroupDysart Scout GroupEastern Downs DistrictEdge Hill Scout GroupEdmonton Scout GroupEkibin DistrictEmerald Scout GroupEnoggera Scout GroupEnterprise Risk SubcommitteeEprapah Campsite, Activity and Environmental Training CentreEprapah Scout FellowshipEsk Scout GroupEverton Park Scout GroupFar North RegionFlinders DistrictFormosa Scout GroupFort Lytton DistrictFraser DistrictFreshwater Scout GroupGatton Scout GroupGayndah Scout GroupGemfields Scout GroupGin Gin Scout GroupGlenore Grove Scout GroupGlenvale Scout GroupGold Coast RegionGoodna Scout GroupGoondi Scout GroupGoondiwindi Scout GroupGordon Park Scout GroupGordonvale Scout GroupGracemere Scout GroupGreenbank Scout GroupGrovely-Mitchelton Scout GroupGumdale Scout GroupGympie DistrictHelensvale Scout GroupHemmant Scout GroupHervey Bay Sea Scout GroupHibiscus Coast DistrictHighfields Scout GroupImbil Mary Valley Scout GroupIndooroopilly Scout GroupIngham Scout GroupInsurance SubcommitteeJimboomba Scout GroupJindalee Scout GroupJohn Oxley DistrictKalinga Scout GroupKallangur Scout GroupKaralee Scout GroupKarana Scout GroupKareeba Scout GroupKaringal Campsite and Activity CentreKawana Scout GroupKedron Scout GroupKenmore Scout GroupKennedy RegionKepnock Scout GroupKingaroy Scout GroupKirwan Scout GroupKurilpa Scout GroupKurwongbah Scout HubLabrador Scout GroupLake Awoonga CampsiteLamington DistrictLandsborough Scout GroupLawnton Scout GroupLimestone DistrictLitigation SubcommitteeLoam Island Scout GroupLogan DistrictLogan Village Scout GroupLongreach Scout GroupLower Burdekin Scout GroupLowood Scout GroupMackay City Central Scout GroupMalanda Scout GroupManly-Lota Scout GroupMaranoa DistrictMareeba Scout GroupMaroochydore Scout GroupMarsden Scout GroupMaryborough West Scout GroupMcDowall-Bunya Scout GroupMillbank Scout GroupMillmerran Scout GroupMission Beach Scout GroupMitchell Scout GroupMoggill Scout GroupMoonaboola Sea Scout GroupMoore Park Beach Scout GroupMoranbah Scout GroupMorayfield Scout GroupMoreton RegionMorningside Scout GroupMount Archer Scout GroupMount Bruce Scout GroupMount Cotton Scout GroupMount Elliot DistrictMount Gravatt Scout GroupMount Gravatt South Scout GroupMount Isa Scout GroupMount Spec DistrictMount Stuart DistrictMoura Scout GroupMudgeeraba Scout GroupMurrenbong Campsite and Activity CentreMurrumba DistrictMuslim Crescent Scout GroupNambour DistrictNarangba Scout GroupNashville Scout GroupNerang Scout GroupNo Attachment to a DistrictNo Attachment to a GroupNo Attachment to a RegionNoosa Sea Scout GroupNorthern Beaches Scout GroupNorthern Moreton Bay RegionNorth Ipswich Scout GroupNundah-Northgate Scout GroupNursery Road School Scout GroupOakey Scout GroupOakleigh Scout GroupOperational Risk SubcommitteeOrmeau Scout GroupOverseas ServiceOyster Point Scout GroupPalm Beach Scout GroupPalmwoods Scout GroupPamphlett Tennyson Sea Scout GroupParadise Point Scout GroupParkwood Heights Scout GroupPialba Scout GroupPimlico Mundingburra Scout GroupPittsworth Scout GroupPort Curtis DistrictPriestdale Scout GroupProgram development teamProserpine Scout GroupProston Scout GroupQueensland Branch Adult Training and DevelopmentQueensland Branch Adventurous Activities TeamQueensland Branch Air Activities TeamQueensland Branch CampsitesQueensland Branch Child SafetyQueensland Branch Committees and CouncilsQueensland Branch Cub ScoutsQueensland Branch Diversity and Inclusion Advisory GroupQueensland Branch Diversity and Inclusion TeamQueensland Branch Environmental Education teamQueensland Branch HeadquartersQueensland Branch Heritage teamQueensland Branch Host teamQueensland Branch International TeamQueensland Branch Joey ScoutsQueensland Branch Major Events TeamQueensland Branch Member ExperienceQueensland Branch People and Culture TeamQueensland Branch Performing Arts TeamQueensland Branch Rover CouncilQueensland Branch Rover ScoutsQueensland Branch ScoutsQueensland Branch Specialist Activities TeamQueensland Branch SuspensionsQueensland Branch Suspensions – Blue CardsQueensland Branch Suspensions – mandatory elearningQueensland Branch Sustainability and Operations TeamQueensland Branch Venturer ScoutsQueensland Branch Youth and Adult Pre-TransfersQueensland Branch Youth CouncilQueensland Branch Youth EngagementQueensland Branch Youth Program ImplementationQueensland Branch Youth Program TeamQueens Park Ipswich Scout GroupRaceview Scout GroupRangeville Scout GroupRavenshoe Scout GroupRedbank Plains Scout GroupRedcliffe DistrictRedlands DistrictRedlands District Scout FellowshipRedlands RevueRichlands-Forest Lake Scout GroupRipley Scout GroupRobertson Scout GroupRochedale Scout GroupRockville Scout GroupRoma Scout GroupRosewood Scout GroupRowallan Park CampsiteRowallan Park FellowshipSamford Scout GroupSandgate Scout GroupSarina Scout GroupScoutreach Scout GroupScouts Of The Air Mt Isa Scout GroupScouts Queensland Health FellowshipSeeonee Park CampsiteShailer Park Scout GroupSherwood Scout GroupSilkstone Scout GroupSir Leslie Wilson DistrictSouth Eastern RegionSpringfield Scout GroupStafford Scout GroupSt Anthonys Scout GroupStanthorpe Scout GroupSt Johns Wood Scout GroupSuncoast RegionSunnybank Scout GroupTablelands DistrictTamborine Mountain Scout GroupTara Scout GroupTaringa Milton Toowong Scout GroupTarragindi Scout GroupTaylor Range DistrictThe Gap Scout GroupToogoolawa School Scout GroupToohey Forest DistrictTyakunda DistrictTyamolum Campsite and Activity CentreUnderwood Scout GroupUpper Mount Gravatt Scout GroupVictoria Point Scout GroupVictor Scout GroupWahminda Park Scout GroupWarripari Scout GroupWarwick Scout GroupWavell Heights Scout GroupWest Centenary Scout GroupWide Bay-Burnett RegionWilston Scout GroupWinton Scout GroupWishart Chester Scout GroupWithcott Scout GroupWonargo Cultural CentreWonargo RevueWoodford Scout GroupWoodlands Scout GroupWoodridge Scout GroupWoogaroo DistrictWoombye Scout GroupWulguru Scout GroupWyaralong DistrictWynnum Scout GroupYandina Scout GroupYeppoon Scout GroupSection of Interest?*Please select a group first. Applicant DetailsPrefixSelect…MrMrsMsMissDrRevOtherFirst name* Middle name Surname* Preferred Name Post Nominals (e.g. OAM) Date of Birth* DD slash MM slash YYYY Gender* Female Male Other Restricted PersonsRestricted Persons To be able to apply for Membership you (or the applicant if under 18 years of age) cannot be a restricted person. You are a restricted person if you have: been issued a negative notice or have had your blue card suspended or are a disqualified person or have been charged with a disqualifying offence that has not been finalised. Confirm Applicant is not a restricted person* I confirm the applicant is not a restricted person If the applicant is a restricted person, please contact the Branch Support Office.Applicant Address DetailsResidential Address* Street Address Address Line 2 City State / Province / Region Postcode AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Postal Address Same as above Street Address Address Line 2 City State / Province / Region Postcode AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Contact InformationPhone*bHomeSilent This number is silent MobilebMobileSilent This number is silent Primary Email Address* Member’s or parent/guardian’s email address to be used for correspondence from Scouts Queensland.Operoo Profile Email Address* An email address connected to an existing Operoo Care profile for the applicant or enter an email address for an invitation to be sent to. Operoo – Member Medical Health Profile Scouts QLD has adopted a health records platform named Operoo. Once your Membership has been approved you will receive a request from Operoo to setup a profile and share it with Scouts Queensland. There is no additional cost to use Operoo as it is part of your Membership fees. We recommend that the Operoo profile email address is a personal email address. If you are an existing Operoo user you should use that same Operoo profile email address to avoid duplicate profiles.Previous Scouting MembershipHas the applicant previously been a member? Yes No State / International?*QLDACTNSWNTSATASVICWAInternationalPrevious Membership Number* If you do not know your previous Membership number, please contact the Branch Support Office. Optional Demographic InformationThe additional information is optional, however we would appreciate you sharing this information with us. We use this information to assist with internal projects, grant applications and identify support needs, as well as to gain a better understanding of our membership. It is not used to determine Membership eligibility.Background / LanguageIs the applicant of Aboriginal or Torres Strait Islander descent? No Yes, Aboriginal Yes, Torres Strait Islander Does the applicant speak a language other than English at home?— Select —No, English onlyCantoneseMandarinGreekItalianVietnameseArabicOther (please specify)If more than one language please indicate the one that is spoken most often.Other Language How well does the applicant speak English?— Select —Very WellWellNot WellNot at allIs English assistance required? Yes No What is the applicant's main ancestry?— Select —EnglishIrishItalianGermanChineseScottishAustralianOther ancestry (please specify)Other Ancestry DisabilityDoes the applicant consider themselves as having a disability, impairment or long-term condition? Yes No If yes, please indicate the areas of disability, impairment of long-term condition Learning Medical Condition Hearing/Deaf Acquired Brain impairment Intellectual Vision Mental Illness Physical Other (Please Specify) Other Disability EmploymentWhich of the following categories best describes the applicant's current employment status? Student Full-Time employee Employer Self Employed (Not employing others) Employed (Unpaid worker in a family business) Part-Time employee Unemployed (Seeking part-time work) Not employed (Not seeking employment) Unemployed (Seeking full-time work) Which of the following classifications best describes the industry of your current or previous employment?? Managers Professionals Technicians and Trade Workers Community and Personal Service Workers Clerical and Administrative Workers Sales Workers Machinery Operators and Drivers Labourers Other Which of the following industry classifications best describes your current or recent occupation? Agriculture, Forestry and Fishing Mining Manufacturing Electricity, Gas, Water and Waste Services Construction Wholesale Trade Retail Trade Accommodation and Feed Services Transport, Postal and Warehousing Information Media and telecommunications Financial and Insurance Services Rental, Hiring and real Estate Services Professional, Scientific and Technical Services Administrative and Support Services – Public Administration and Safety Public Administration and Safety Education and Training Health Care and Social Assistance Arts and Recreation Services Other Services Religion/Spiritual AffiliationWhich religion/spiritual affiliation does the applicant have? AOG Anglican Assembly of God Baptist Buddhist Catholic Christian Church of Christ Church of Scotland Church of the Torres Strait Congregational Greek Orthodox Hindu Jehovah Witness Jewish LD Latter Day Saint Lutheran Methodist Muslim Orthodox Pentecostal Presbyterian Protestant Roman Catholic S.D. Adventist Salvation Army Uniting Church No Religion Other Youth Member Parent/Guardian Contact InformationParent 1First name* Surname* Preferred Name Relationship to Applicant*Select…FatherFoster ParentGrandfatherGrandmotherGuardianMotherSelfStep FatherStep MotherParent/Guardian Member Number If they are a member of Scouts QueenslandMobile*PhonePrimary Email Address* Parent 2First name Surname Preferred Name Relationship to ApplicantSelect..FatherFoster ParentGrandfatherGrandmotherGuardianMotherSelfStep FatherStep MotherParent/Guardian Member Number If they are a member of Scouts QueenslandMobilePhonePrimary Email Address Appointment SelectionWhich appointment are you applying for?*Loading Appointment list…Volunteer Agreement* I understand that I am applying for a volunteer position with Scouts Queensland Blue CardThe blue card system is Queensland’s Working with Children Check. Find out more information about the blue card system here. As a child safe organisation, Scouts Queensland requires adult members to have a blue card. If the applicant holds a blue card, enter the blue card number below. If the applicant does not hold a current Blue Card, please register online via the Blue Card Services website and include the Online Account Number below. Blue Card Number* RefereesAs part of the application process two referees are required for all new and returning Members. Note: Team Leader and/or family members are excluded from providing references. Only one referee can be a current member of Scouts Queensland.Referee 1 Name* Address* Phone* Relationship* Referee 2 Name* Address* Phone* Relationship* Mutual Agreement In consideration of The Scout Association of Australia, Queensland Branch Inc, (‘the Association’) accepting me as a member or supporter involved in the Association, I agree to the following: (check each item to indicate agreement)As an Adult volunteer the applicant has the right to: work in a healthy and safe environment, have their application for membership considered and, if successful, be engaged in accordance with equal opportunity and anti-discrimination legislation, be adequately covered by relevant insurance, be given accurate and truthful information about Scouting, be reimbursed for agreed out of pocket expenses, be provided a copy of Scouting’s policies and rules and any other procedure that may affect their undertakings, have a role description and agreed commitment, have access to grievance procedures, be provided with induction to Scouting, have their confidential and personal information dealt with in accordance with the provisions of the Privacy Act, be provided with encouragement, support, training and mentoring to fulfil their role, be provided with opportunities for growth and development. Acknowledge Associations Mutual Agreement* I have read and acknowledge the Association’s commitment to the applicant. As an Adult volunteer the applicant has a responsibility to: promote a culture of Scouting being a Child Safe Organisation, and adhere to the National Child Protection Policy, live by the Scout Promise and Law and accept the Code of Ethics and Code of Conduct, work to achieve the Vision, Mission, and Purpose of Scouts Australia, adhere to the Policies and Rules of Scouts Australia and of the Branch in which they volunteer, represent and promote Scouting to the community, meet the agreed goals and timelines in their development plan. Acknowledge Associations Mutual Agreement* I have read and acknowledge the applicant’s commitment to the Association. Publications I acknowledge having been advised of: Policy and Rules of the Association (P&R) and Queensland Branch Scouting Instructions (QBSI) Constitution and Bylaws of the Association; Code of Ethics and Code of Conduct for Adults in Scouting (See Policy & Rules of the Association) Privacy Act Mutual agreement (See Policy & Rules of the Association) Acknowledge Associations Publications* I understand it is my obligation to become familiar with the above publications, and agree to abide by them, and any other policies, rules, regulations or directives as may be issued by The Association from time to time. Child Safe & WHS Training I undertake to complete the two mandatory online training module, Child Safe Scouting and WHS for Scouting, within 3 months of date of membership and understand these modules are to be renewed every 3 years as part of the National Child Safe policy or my membership may be terminated.3 Child Safe & WHS Training* Yes Adult Training I undertake to complete the proficiency components of the Adult Training Program (where applicable) to qualify for a Certificate of Proficiency within 12 months from date of membership, and to further develop my skills as a leader by availing myself of additional training opportunities, including completion of my training to Wood Badge Standard within three years of acceptance as a leader. I understand that the issue of a Certificate of Adult Membership or Certificate of Proficiency can be recalled at any time without reason and, in that event, I agree to return my Certificate and all Scout property within 7 days of receiving notice from the Association.4 Adult Training Program* Yes Injury Disclaimer I acknowledge and voluntarily accept the risks of injury associated with participating in the Association’s activities from time to time, although I undertake to exercise the utmost care, diligence and attention to ensure the safety of members and other leaders at all times. Except to the extent that the Association, its officers, leaders, agents and members are entitled to be indemnified under a policy of insurance maintained by the Association, I hereby release the Association, its officers, other leaders, agents and members from any liability (including liability involving negligence) and waive any claim I may otherwise have in relation to my participation in any activity connected with the Association, or when travelling to and from any such activity.5 Injury* Yes Medical Treatment Disclaimer I authorise the Association, in the event of any injury or illness occurring to me in connection with any activity connected with the Association, to obtain on my behalf and at my expense any medical treatment as may be considered appropriate by the Association. I agree to pay on demand by the Association any medical, hospital or other expenses incurred by the Association on my behalf.6 Medical* Yes Terms of Appointment I understand the terms of appointment are for up to three years, with continuance being by mutual agreement at that time.7 Terms of Appointment* Yes Referee Check I authorise a referee check as to my character to be made.8 Referees* Yes Release and IndemnityIn consideration of The Scout Association of Australia, Queensland Branch Inc accepting me, my child as a member or supporter or accepting me or my child as a non-member partaker in an activity(s) I/we agree to release, indemnify and save harmless; and at all times hereafter to keep released, indemnified and saved harmless the indemnified persons (as defined in Definition A) from and against all liability, claims, suits, demands or actions of whatsoever nature or description, including liability, claims, suits, demands or actions for negligence directly or indirectly arising out of or in relation to my/my child’s attendance or conduct at, or travel to or from any Scouting Activity. I/we agree to be bound by Scouts Australia’s Policies & Rules, Scouts Queensland Constitution and Bylaws and Queensland Branch Scouting Instructions (QBSI) – those existing as at the time of acceptance of me as a Member/or non-Member participating in a Scouting activity and thereafter as lawfully modified and amended or added to from time to time. Release and Indemnity 1* Yes I/we acknowledge that the intent of this Indemnity is that it may be pleaded in limitation of liability by the indemnified person with respect to any claim that may be brought against the indemnified person.Release and Indemnity 2* Yes I/we acknowledge that the intent of this Indemnity is to benefit the Indemnified person and agree for the purposes of Section 55 of the Property Law Act (Qld) that acceptance of me as a Member of the Scout Association of Australia – Queensland Branch Inc or as me as a non-Member attending a Scouting activity will constitute an acceptance by all the Indemnified persons of the benefit conferred by this application for Membership/non-Member activity advice.Release and Indemnity 3* Yes I authorise the Scout Association of Australia – Queensland Branch Inc and all other branches of the Scout Association of Australia in the event of accident or illness to myself to obtain such medical assistance or treatment as may be necessary and for this purpose to engage any doctors nursing assistance or hospital accommodation or other procedures and in such an event I agree to pay for those expenses and if necessary reimburse the Scout Association of Australia – Queensland Branch Inc or any other branch of the Scout Association of Australia for such expenses on demand.Release and Indemnity 4* Yes I acknowledge that as Member/Supporter I may be exposed to risk of injury as a result of participating in Scouting activities.Release and Indemnity 5* Yes I acknowledge that if the Scouting Association of Australia-Queensland Branch Inc permits the Member to partake in Scouting activities such permission constitutes consideration for the above indemnity.Release and Indemnity 6* Yes I/we acknowledge that the intent of this Indemnity is that it may be pleaded in limitation of liability by the indemnified person with respect to any claim that may be brought against the indemnified person. Release and Indemnity 7* Yes I acknowledge that I have been given an opportunity to read and consider this indemnity and have read and considered it to my satisfaction and I accept those terms.Release and Indemnity 8* Yes It is acknowledged that the information contained on this form will be stored digitally by the Association and the Association will hold an electronic copy of this form and the information contained in it. Consent is hereby given to these actions proposed by the Association.Release and Indemnity 9* Yes Definition A: Indemnified Persons The term “Indemnified Persons” means and includes: The Scout Association of Australia, Queensland Branch Inc. (herein referred to as Scouts Queensland); Scouts Australia; all Branches of Scouts Australia; all subsidiary companies of Scouts Queensland; all subsidiary companies of Scouts Australia; every Director, Executive Officer, Officer, Employee, Leader, Member, Servant or Agent or person holding Appointments from Scouts Queensland or Scouts Australia or any Branch of Scouts Australia and any persons retained in any way by Scouts Queensland or Scouts Australia whether in official or unofficial capacity and whether a volunteer or otherwise to supervise, direct, watch over, or assist Members of Scouts Queensland or Scouts Australia thereof in Scouting Activities.Photography Consent As a Member or Supporter of The Scout Association of Australia, Queensland Branch Inc. members participate in activities which may be photographed or filmed for publicity and archival purposes. This enables us to raise the profile of Scouting within the community. Photographs, footage and information gathered may be used in The Scout Association of Australia, Queensland Branch Inc promotional material including but not restricted to: newsletters, annual reports, brochures, posters, videos, letters and website. The Scout Association of Australia, Queensland Branch Inc would be happy to send you copies of promotional material if requested.Release and Indemnity 9 Photography* I consent to photographs and video of the applicant being used for publicity purposes I do not consent to photographs and video of the applicant being used for publicity purposes Declaration and Undertaking I authorise Scouts Australia (QLD Branch) to utilise my Blue Card in the assessment of my Application for Adult Membership, in conjunction with my declaration below and agree that it may maintain a copy of this Certificate if deemed necessary. I have reviewed this document in detail and am satisfied that I understand it. In addition, I make the following declarations in support of my application: Have you ever been found guilty of an offence of any sexual nature committed in Australia or any other country?Declaration and Undertaking 1* Yes No Have you ever been charged, reported, or defended in a court of law any allegation of sexual abuse, assault or a sexual offence of any kind in Australia or in another country?Declaration and Undertaking 2* Yes No Have you ever been (or are you currently) subject to any restrictions regarding your contact with children in any employment, volunteer, or personal capacity?Declaration and Undertaking 3* Yes No Have you ever been dismissed or resigned as a volunteer or employee (or reported by any authority) for improper conduct relating to children in any jurisdiction?Declaration and Undertaking 4* Yes No Have you been named as the defendant in an Intervention Order, Restraining Order, Apprehended Violence Order or Domestic Violence Restraining Order, or equivalent, in any jurisdiction?Declaration and Undertaking 5* Yes No I am a restricted person (been issued a negative notice or a suspended blue card or a disqualified person or been charged with a disqualifying offence that has not been finalised)Declaration and Undertaking 6* Yes No You commit to advise Scouts Australia (QLD Branch) if you are ever approached by the authorities in relation to improper conduct relating to children, assault, or any sexual offence by you, whilst you are a member.Declaration and Undertaking 7* Yes No If you answered “yes” to any of questions 1 to 6 above, please submit a detailed summary of the circumstances surrounding the situation with your application.You can provide details in the notes field on the following page, or provide details to your formation’s leader in charge who is going to be involved in the completion of your application. This should include dates and, where applicable, the reasons for the decision, conditions of employment, offence type and date, the court in which the matter was heard, and the status of any proceedings. Please email to membership@scoutsqld.com.au. Scouts, Queensland reserves the unfettered right to accept or reject your application per Scouts Australia Policy and Rules and the Branch Constitution. Additional InformationIf there’s any additional information you feel is relevant to your application, please add it in the field below.Additional InformationSignature of Applicant or Parent/GuardianTo complete your application, please sign the form with your mouse, or touch screen if you’re on a mobile device.Signature*
