SACTIVITY INFORMATION - Permission & Health Form

Please complete the following information below for …………..camp and return to Scouts@3rdreadingscoutgroup.org.uk

All forms are required by ………….. 

Section :
 
Site : 

On : 

BASIC DETAILS

Name………………………………………….

DOB ……………………………………………..

Contact number for collection at end of camp…………………………………………………….

ACTIVITIES

Can your son/daughter swim 50 metres and tread water?  ………………..

Can your son/daughter bathe under careful supervision? …………………

Is there any medical reason why your son/daughter can not take part in any of the activities 
……………………………………… …………………………

CONTACTS
Name & Address of your Doctor ………………………………………………………………………………………………………………………………………………………………………………………………

During the event I can be contacted on ……………………………………………………

MEDICAL

Does your son/daughter suffer from any of the following? If so please state treatment needed (continue on the back of sheet if needed)

EPILEPSY………………………………………………………………………………….TRAVEL SICKNESS………………………………………………………………………
ECZMA…………………………………………………………………………………….
ASTHMA…………………………………………………………………………………..
ALLERGIES.(Bites, FOOD, Medicine)………………………………………………
Any other condition………………………………………………………………………...

Is your son or daughter taking any medication at present? If so please give details………………
………………………………………………………………………………………………

Do you have any special dietary needs?………………………………………………

FIRST AID
Is your son / daughter allergic to any of the following that we have in out first aid kit and may use

Sticking plaster……..                                      	Piriton syrup……………………..

Germolene or Savlon anesthetic creams……….        Carpol……………………

Sun Cream ………………………                   	Cleansing Wipes ……………….

Savlon Wound Wash  …………………		AntiHistomine Cream ………..

Would you be happy for us to use the above with your child  YES / NO

PERMISSION

I give permission for my son / daughter to participate in the  …………….. Camp on ……………………………

I understand that the Scout Leader reserves the right to send any participants home if necessary. If it becomes necessary for my child to receive medical treatment and I cannot be contacted by telephone or any other means to authorize this, I hereby give my general consent to any necessary medical treatment and authorize the Scouter in charge of the activity to sign any document required by the hospital authorities.

Signature of parent/guardian 	

Date: 	

Note: The medical profession takes the view that the parent’s consent to medical treatment cannot be delegated. This view is explicit in the Child Act 1989. Thus medical consent forms have no legal status and a doctor/nurse insisting on the consent of a parent to a particular treatment has the right to do so. For this reason we do not recommend that Leaders insist on parents signing the statement above. However, it can be a comfort to medical staff to have general consent in advance from parents or to have a Leader on hand able to sign forms required by medical authorities.