Adult Membership Application

This form is for anyone aged 18 years or over who wants to become an adult member of Scouts ACT.

Venturers and Rovers are youth program sections, but once you turn 18 years of age you must hold adult membership to meet child safety requirements.

Use this form to join as an

Adult Leader
Adult Supporter
Scout Fellowship member
Rover
Venturer aged 18+years

For other changes (additional role or role transfer), use the Secondary Appointment or Transfer forms.

Any questions? Please contact admin@scoutsact.com.au

Section 1 — About the Applicant

Please enter your full name exactly as it appears on your official identification.

Title *

First Name *

Middle name/s

Last Name *

Previous name

Preferred name *

Gender *If other, please detail below.

Date of birth *

Other

Are you of Aboriginal or Torres Strait Islander origin? *

What language/s do you speak at home? *

Email Address *

Telephone *

RESIDENTIAL ADDRESS *

Street address *Street address line 2

Suburb *

State *

Postcode *

Is your postal address the same as your home address? *

YesNo

POSTAL ADDRESS *

Postal address *Postal address line 2

Suburb *

State *

Postcode *

Occupation

Have you previously been involved in Scouting in Australia, either as a youth or adult member? *

If yes, in which branch were you involved? *

Please provide the name(s) of the Group(s) or Unit(s) with which you were involved, the dates of your involvement, and whether you were a youth or adult member. *

Have you previously been involved in Scouting outside of Australia, or in Guiding or similar organisations? Please provide details.

Section 2 — Appointment Sought

Which formation (Scout Group or Rover Unit) do you wish to join? *

LIC Email (Functional) *

For what type of adult membership are your applying? *

What will be your role in Scouts ACT? Please enter your specific role. For example Cub Leader, Group Committee Treasurer, Rock Activity Leader. *

Section 3 — Working with Vulnerable People (WWVP) Card

Scouts ACT requires a copy of the front and back of your ACT Working with Vulnerable People (WWVP) card. This is part of our child safe requirements and helps ensure the safety of all young people in our programs. All persons aged 18 years or older in Scouting are required to hold a valid WWVP registration. Your application cannot progress until your WWVP card has been received.

Do you hold a current Working with Vulnerable People card? *

YesNo

Upload a copy of the front and back of your WWVP card below *

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jpg, jpeg, png, pdf

Section 4 — Referees

All applicants must nominate two referees who can speak to their suitability. Referee requirements:

Must not be related to you
Must have known you for at least two years
One referee may be a Member of Scouting
One referee must not be a Member of Scouting
All referees must be over 18 years of age

For applicants with prior Scouting experience (Scouts ACT or another branch) one referee should be a current or former Leader or Scouting Manager who can speak to your previous involvement.

Please choose referees who know you well and who can provide a reliable reference.

REFEREE 1

REFEREE 2

Full name *

Email *

Telephone *

What is your relationship to the referee? *

Section 5 — Child Safety and Legal Declarations

Scouts ACT is committed to providing a safe environment for children and young people. The following questions form part of our child safe obligations and are required to assess an applicant’s suitability for Adult membership. All information provided will be treated confidentially.

Have you ever been found guilty of a sexual offence in Australia or in any other country? *

YesNo

Have you ever been charged, reported to authorities, or been the subject of legal proceedings in relation to any allegation of sexual abuse, sexual assault, or a sexual offence of any kind in Australia or in any other country? *

YesNo

Have you ever been, or are you currently, subject to any restrictions on your contact with children in any employment, volunteer, or personal capacity (excluding child visitation rights as part of a Divorce Agreement)? *

YesNo

Have you ever been dismissed, voluntarily resigned, or reported by an authority for improper conduct involving children in any jurisdiction? *

YesNo

Have you ever been named as a defendant in an intervention order, restraining order, apprehended violence order, domestic violence order, or an equivalent order in any jurisdiction? *

YesNo

Please explain the circumstances and provide any relevant details. *

Upload any relevant documents

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Accepted file formats: JPG / JPEG, PNG, or PDF; Maximum file size: 5 MB per file

Section 6 — Conditions for Acceptance of Adult Members

Part A – Release and Indemnity

I acknowledge that:

The Scout Association of Australia ACT Branch Inc (the Association) is not responsible for any injuries or property damage occurring where the Association has not been negligent.
As a condition of joining and participating in activities, I release and indemnify the Association in respect of any injury or damage where the Association is not indemnified by insurance.

In consideration of being permitted to:

join the Association
participate in activities organised by or for the Association
use equipment and facilities provided by or for the Association

I hereby:

For myself, my heirs and assigns: release and forever discharge
And agree to be liable for and to indemnify

the Association, its officers, leaders, employees, agents and contractors (voluntary or paid) (the beneficiaries), jointly and severally, from and against any loss, damage, liability, actions, suits, claims, costs or demands arising from any accident, illness, injury, death, or damage to me or any other person:

during or as a result of my participation in any activity connected with the Association
while travelling to or from any such activity

Insurance Limitation This release and indemnity does not extend to circumstances where the beneficiaries may claim indemnity under any policy of insurance held by the Association and the insurer agrees (or is ordered) to provide indemnity.

I have read, understood and agree to the Release and Indemnity. *

Part B - Authority to obtain necessary medical treatment

I authorise the beneficiaries to obtain any medical assistance which in the opinion of the beneficiary I require, including hospital accommodation in the event that I suffer any accident or illness and am unable to consent to such treatment on my own behalf. In the event that medical expenses are incurred which the beneficiaries cannot claim under any policy of insurance, I agree to pay for those expenses.

I have read, understood and give authority to obtain medical treatment

I have read, understood and give authority to obtain medical treatment. *

Part C - Acknowledgement of Policies, Rules, and Scout Code

I agree to abide by all policies and rules now in force or issued in future by The Scout Association of Australia or The Scout Association of Australia ACT Branch Inc.

I agree to return:

my Certificate of Adult Membership and/or Appointment (if issued), and
any other Scout property

when I cease performing my functions or when called upon to do so.

I acknowledge that only an Adult Leader authorised via a Certificate of Adult Appointment may take charge of a Unit or Youth Members.

I acknowledge that I have read, understood, and agree to the following, available via the National Policy and Rules:

Code of Conduct
Mutual Agreement
Code of Ethics

I will do my best to live by the Scout Promise and Law.

I acknowledge that if my membership is cancelled for breach of the Code of Conduct, this information will be made available to Scouts Australia and its Branches.

I have read, understood and agree to the expectations of me as a member of Scouts ACT. *

Part D - Character, Background and Suitability Checks

I authorise the Association to make any inquiries about my character, background and suitability for appointment as an adult member.

I agree *

Part E - Privacy Notice - Our Commitment to You

Scouts ACT collects personal information for:

administering activities and ensuring member health and safety
communicating with members, parents or carers
obtaining help or participation from parents and carers

This may include sensitive information (e.g., health or professional skills).

Information may be disclosed to:

Scouts ACT staff, Leaders, Youth Helpers, and some Branch members, or
Agents such as mailing houses assisting with communication or administration

Individuals may access their personal information by contacting Scouts ACT via admin@scoutsact.com.au.

I have read, understood and agree to the Scouts ACT privacy commitment. *

Part F - Privacy Notice - Your commitment to Scouts ACT

In my Scouting role I may access private and personal information (PPI) of others. I commit to:

handling PPI responsibly and legally
complying with Scouts ACT and Scouts Australia privacy policies
safeguarding system access
not sharing passwords
not sharing sensitive information except where required for a Scout role
maintaining devices and systems to avoid compromising Scouts ACT data
using data only for authorised purposes
contacting the Executive Officer if:
- I suspect or observe a data breach
- I am uncertain about my obligations
- I no longer require access (and will destroy any stored data)

I understand and agree to adhere to Scouts Australia and Scouts ACT privacy requirements. *

Part G – Participant Acceptance

By submitting this form, I confirm that:

I am applying for appointment as an Adult Member of The Scout Association of Australia ACT Branch Incorporated;
The information I have provided is true and correct.
I have read, understood and agree to the commitments, permissions and acknowledgements outlined in Parts A–G of this form.

I confirm *

Date submitted *

LIC Review Date *

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