Lifesaving Award
User Manual: LifesavingAward
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Recommendation for Lifesaving or Meritorious Action Award Upon consideration of the evidence submitted from all sources, as set forth in this application, we respectfully recommend that the National Court of Honor grant the award checked below. Note: If the action being considered is deserving of merit but does not qualify for a national award, do not submit this form. The Local Council Certificate of Merit, No. 606760, is suitable for this purpose. Instructions 1. This application must be used. 2. Provide the full name of applicant to be honored, exactly as it should appear on the certificate if the award is granted. 3. Provide as much information as necessary using the space provided on this form. No additional documents should be attached. 4. All recognitions are reserved for members who were registered at the time of the action. 5. Lifesaving actions or meritorious actions performed as part of the duty of a trained lifesaver—i.e., doctor, nurse, lifeguard, first responder—will not be considered. 6. Boy Scouts of America employees are not eligible. 7. No case should be forwarded to the council without a signed statement from the applicant and an eyewitness. 8. No application may be considered after a lapse of 12 months of the incident. 9. Separate applications are required if more than one member is being recognized for recognition. 10. The council committee must investigate the case, interview the principals and witnesses, secure necessary signed statements, and make a recommendation based upon full knowledge of the facts. It is recommended that this committee meet within 30 days of the receipt of the recommendation. 11. The council committee bears the responsibility to write a summary of the event and complete the application in detail that pertains to the case. 12. Upon approval of the council committee and Scout executive, the council will submit this application electronically to awards@scouting.org. Please select the level in which you are nominating for: LIFESAVING AWARDS (See clause 1.) These awards recognize the attempt to a save life and an accompanying measure of risk to self. Honor Medal With Crossed Palms. The individual has demonstrated unusual heroism and extraordinary skill or resourcefulness in saving or attempting to save a human life at extreme risk to self. “Extreme risk” shall mean of greatest severity to one’s self. Honor Medal. The individual has demonstrated unusual heroism and skill or resourcefulness in saving or attempting to save a human life at some risk to self. MERITORIOUS ACTION AWARDS (See clause 2.) These awards recognize notable acts of service that need not involve attempts of rescue or risk to self but put into practice Scouting skills and/or ideals. Medal of Merit. The individual has performed an act of service of rare or exceptional character that reflects an uncommon degree of concern for the well-being of others. National Certificate of Merit. The individual has performed a significant act of service that is deserving of special recognition. Applicant Information Name ___________________________________________________________________________________________ Age at time of action _____________ Approximate height ________________ Approximate weight _________________ Parent’s name ____________________________________________________ Phone No. _______________________ Home address ____________________________________________________________________________________ City _________________________________________________ State ______________ Zip code _________________ The candidate is registered as a Tiger Cub Cub Scout Webelos Scout Boy Scout Varsity Scout Venturer Adult in Pack _______ Troop _______ Team _________ Crew ________ Ship _______ Rank at time of action ________________ If an adult, indicate present office in Scouting __________________________ Rescued Person Information Name __________________________________________________________ Phone No. ________________________ Address __________________________________________________________________________________________ City _________________________________________________ State ______________ Zip code _________________ Age at time of action _____________ Approximate height ________________ Approximate weight _________________ Name and location of place where action occurred ________________________________________________________ _________________________________________________________________________________________________ Date of incident __________________________________________________ Time of incident ____________________ Summary of the Action A short summary describing the incident or action is required based on the council committee’s study of all aspects of the case and on interviews with the principals and witnesses. ________________________________________ Council committee chair’s signature __________________________________ Date For First-Aid Cases Explain how first aid was administered by this currently registered youth or adult member instrumental in saving a life, if any. _________________________________________________________________________________________________ _________________________________________________________________________________________________ What Scout first-aid skills were used? (CPR, control of bleeding, choking emergency, etc.) _________________________________________________________________________________________________ Explain the circumstances such as to tax his/her cool headedness? ___________________________________________ _________________________________________________________________________________________________ Was he/she assisted? ____________ If so, by whom and how much? _________________________________________ _________________________________________________________________________________________________ Did the assisted person survive? ___________ If survived, give details of the method used. ________________________ _________________________________________________________________________________________________ Was the Scout training employed in the rescue and resuscitation? ____________ Give details _____________________ _________________________________________________________________________________________________ For Rescue From Fire Dimensions of the room or rooms involved in the rescue ____________________________________________________ What was the location of the fire at the time of the rescue? __________________________________________________ _________________________________________________________________________________________________ Where was the rescued person when reached by the rescuer? _______________________________________________ _________________________________________________________________________________________________ How far did the rescuer have to go to reach the rescued? ___________________________________________________ Did the rescued person or persons have to be transported to safety?__________________________________________ Did dense smoke impede the rescue? ______________ Did the rescuer know the building layout? __________________ Describe in detail the danger to the rescuer at the time of the rescue. _________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ Did the assisted person survive? ___________ If survived, give details of the method used.________________________ _________________________________________________________________________________________________ Was Scout training employed in the rescue and resuscitation? __________ Give details __________________________ ________________________________________________________________________________________________ For Ice Rescue Thickness of ice at and near the point of rescue __________________________________________________________ Depth of water at and near the point of rescue ___________________________________________________________ Manner in which the rescuer moved over ice ____________________________________________________________ Distance traveled by the rescuer a) From shore to breakthrough ___________________________________________________________________ b) Over dangerous ice __________________________________________________________________________ Location of ladders, rope, planks, etc., if any, and use made of them __________________________________________ Did ice break under the rescuer? _________ If so, at what point and in what depth of water? _______________________ _________________________________________________________________________________________________ Did the rescuer fall in? ____________ If so, how did the rescuer get out?_______________________________________ _________________________________________________________________________________________________ Did the assisted person survive? ___________ If survived, give details of the method used.________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ Was Scout training employed in the rescue and resuscitation? __________ Give details __________________________ ________________________________________________________________________________________________ Is the rescuer regarded as a good, fair, or poor swimmer?___________________________________________________ For Water Rescue General weather and water condition, including the approximate temperature____________________________________ (Storm, high seas, fair, calm, cold, etc.) Lake, river, or ocean? _____________ Name of lake, river, or ocean __________________________________________ Condition of bottom (weeds, snags, rocks, sand, mud) _____________________________________________________ Still or running water? _________________________ If running, speed of current? ______________________________ Were others in addition to the rescuer on the scene when the accident occurred? ________________________________ Was the rescuer assisted in rescue? ___________ If so, by whom? ___________________________________________ Did anyone else attempt the rescue and fail? ___________ If so, by whom? ____________________________________ Was the rescue made by use of boat, buoy, or other equipment, or was it a swimming rescue?______________________ If by swimming, was the boat or other equipment that could have been used at and?______________________________ If a swimming rescue, how far did the rescuer swim in order to reach person assisted? ____________________________ Depth of water at point where rescue was made __________________________________________________________ How far was it necessary to tow the person assisted in order to stand up or reach safety? _________________________ What clothes was the rescuer wearing at the time of the rescue? _____________________________________________ How was the assisted person clothed? _________________________________________________________________ Was the person unconscious when rescued? ____________________________________________________________ Did the assisted person struggle or grasp the rescuer while being aided? ______________________________________ If so, did it result from bad judgment or a careless approach? ________________________________________________ Was it necessary to go underwater to find the person assisted? ______ How many times? _____ At what depth?_______ Did the assisted person survive? _____________ If survived, give details of the method used. ______________________ _________________________________________________________________________________________________ Was Scout training employed in the rescue and resuscitation? __________ Give details___________________________ _________________________________________________________________________________________________ Is the rescuer regarded as a good, fair, or poor swimmer? __________________________________________________ Miscellaneous Cases In cases that cannot be covered under any of the sections, give as much data and as many details as possible to help the National Court of Honor to evaluate the case, paying particular attention to the use of Scout training. Applicant’s Statement Recommended for Recognition A personally prepared and signed statement by person performing action describing the incident is required. Date _______________________ Email ___________________________________________ _________________________________________________ (Signature) ___________________________________________ (Printed name) Rescued Person’s Statement (optional) Date ____________________ Email ______________________________________________ _________________________________________________ (Signature) ___________________________________________ (Printed name) Witness Statement A personally prepared and signed statement by each witness, describing the action as he or she recalls the details is required. Include name, address, and phone number of each witness. Date _________________________ _________________________________________________ (Signature) ___________________________________________ (Printed name) Address ________________________________________________________________________________________ City _____________________________________ State _____________________ Zip code ____________________ Phone No. _______________________________ Email _________________________________________________ Second Witness Statement, if any A personally prepared and signed statement by each witness, describing the action as he or she recalls the details is required. Include name, address, and phone number of each witness. Date _________________________ _________________________________________________ (Signature) ___________________________________________ (Printed name) Address________________________________________________________________________________________ City _____________________________________ State _____________________ Zip code ____________________ Phone No. _______________________________ Email _________________________________________________ RULES AND REGULATIONS of the BOY SCOUTS OF AMERICA RULES AND REGULATIONS of the BOY SCOUTS OF AMERICA Article X, Section 5, Clause 1 Lifesaving Awards Article X, Section 5, Clauses 2 and 3 Meritorious Action Awards Clause 1. Lifesaving Awards. Recognition may be given to a youth member or adult leader of the Boy Scouts of America where the evidence presented to the National Court of Honor, in accordance with prescribed regulations, shows that he or she saved or attempted to save life under circumstances which indicate heroism and risk to self. The court will give consideration to resourcefulness and to demonstrated skill in rescue methods. In no case shall recognition be given where it appears that the risk involved was merely in the performance of duty or the meeting of an obligation because of responsibility to supervise and give leadership to the persons whose lives were saved. The awards are: Clause 2. Meritorious Action Awards. Recognition may be given to a youth member or adult leader where the evidence presented to the National Court of Honor, in accordance with prescribed regulations, shows that a significant or outstanding act of service, of an exceptional character, was performed. The action taken need not involve attempts of rescue or risk to self but must put into practice Scouting skills and/or ideals. Recognition shall not be given where it appears that the action involved was merely in the performance of duty or the meeting of an obligation. The awards are: Medal of Merit. The Medal of Merit may be awarded to a youth member or adult leader who has performed an act of service of a rare or exceptional character that reflects an uncommon degree of concern for the well being of others. b) National Certificate of Merit. The National Certificate of Merit may be awarded to a youth member or adult leader who has performed a significant act of service that is deserving of special national recognition. a) Honor Medal With Crossed Palms. The Honor Medal With Crossed Palms may be awarded in exceptional cases to a youth member or adult leader who has demonstrated unusual heroism and extraordinary skill or resourcefulness in saving or attempting to save life at extreme risk to self. b) Honor Medal. The Honor Medal may be awarded to a youth member or adult leader who has demonstrated unusual heroism and skill in saving or attempting to save life at considerable risk to self. a) Clause 3. All applications should be submitted to the National Court of Honor through a local council upon duly prescribed forms, and it shall be within the discretion of the National Court of Honor to determine which type of recognition, if any, shall be given. Recipients of these awards must be registered members of the Boy Scouts of America at the time the action was performed. Awards are made in the name of the Boy Scouts of America. Council’s Nomination Information The ___________________________ Council, BSA, proudly approves ________________________________________ (Name of candidate) to receive the ____________________________________. We attest that this candidate was a registered member of the Boy Scouts of America at the time of the action described herein, and that the procedures outlined on this form have been followed. __________________________________ _______________________________________ ___________________ ______________________________________________ Scout executive’s printed name ______________________________________________________ Scout executive’s signature ___________________________ Date Council chair’s printed name Council chair’s signature Date We plan to present the award on ________________________________________________. Date Council name _____________________________________ Council No. ______________________________________ Contact name _____________________________ Phone No. _____________________ Email_____________________
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