Troop 272 Incident Report – Infraction Form

Date of event:	Click or tap to enter a date.
Name of Scout:	Click or tap here to enter text.
Name of Scout Leader:	Click or tap here to enter text.

Scout Leader’s Description of Offense:

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Witness(es) (if any):	Click or tap here to enter text.

I hereby agree that the above description is true and correct to the best of my knowledge. Also, after completing the above description I will provide it to the Scout in question and allow him an opportunity to provide his own accounting of the event(s) in question. Upon completion of the two accountings the Scout’s parent(s) will be required to sign the form acknowledging that they have been apprised and informed of the event(s). The form will then be forwarded to the Troop Committee Chair for resolution.

Scout Leader Signature:	Date: Click or tap to enter a date.

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Troop 272 Incident Report (Continued)

Scout’s Description of Event(s):

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Witness(es) (if any):	Click or tap here to enter text.

I hereby agree that the above description is true and correct to the best of my knowledge. I understand that this form MUST be signed by both myself and my parent(s)/guardian(s) acknowledging that we have been apprised and informed of the event(s) in question.

Signature of Scout:	Date:

Signature of

Parent(s)/ Guardian:	Date:

*NOTE:	The Scout will not be allowed to participate in any Troop activities until COMPLETED form is returned to the Scoutmaster.

Troop Committee Actions:

Date discussed with Scout Leader:	Click or tap to enter a date.
Date discussed with Scout:	Click or tap to enter a date.
Date discussed with Parent(s):	Click or tap to enter a date.
Date discussed with Committee:	Click or tap to enter a date.

Resolution:

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