Lodge publication consent form
Wagion Lodge #6
Westmoreland-Fayette Council
Boy Scouts of America
Name: _________________________________
Age: _________________________________
Position in _________________________________
lodge:
I hereby give instructions regarding the use of my / my son's name in the
following manner (initial all those that apply, cross out those that do not).
______Name may be identified on the lodge website.
______Picture may be identified with name on the lodge website.
______Scout or Scouter is willing/allowed to receive communication via E-Mail.
______Special @OA6.ORG Wagion E-Mail address may be assigned.
This email address will be used only for lodge business and will be used to prevent
publication of person's real email address.
______Email contact info may be used by members of the executive committee for
discussion or announcements.
______Email contact info may be published in the lodge website.
Signature required (must be signed by a parent/guardian if scout is under age 18.
Signature: _________________________________
Date: _________________________________
Relation to _________________________________
Scout:
