Camp Information Form Please complete the form below, and then submit it. Camp Information Form – Worthing Scouts "*" indicates required fields 1Young Person Details2Permissions Event DetailsWorthing Scouts Overnight upcoming camp, information confirmation and permission formUnit & Leader to send this form to:*Please selectAl – Excelsior & Nomads ESUSteven – Tsunami ESU (Bognor Regis District)Camp Details & DateLocation, or name of camp, and the dates your Explorer is attending. Name, location of camp this form relates to.*Confirm the name, description of the camp your are confirming these details, and giving permission for. Attending From Date*Date arriving at camp DD slash MM slash YYYY Attending to Date*Date leaving camp. DD slash MM slash YYYY Young Person DetailsYoung Person's Name* First Last Date of Birth* Day Month Year Have they been in contact with any infectious diseases within the last 3 weeks?* Date of last tetanus immunisation* Medicines currently being taken* Do they have any allergies to food, medicines or other?* Do they have any special dietary needs?* Do they have any additional needs?* Name, address and telephone number of own Doctor*Primary Contact 1* Name Relationship to Young Person Phone*During the event, I can be contacted in an emergency onPrimary Contact 2* Name Relationship to Young Person Phone*During the event, I can be contacted in an emergency onIf you are going to be away at anytime during this camp, we must have alternative contact details for you, or alternatively another family member or friend who has agreed to be contacted should your Scout or Explorer become unwell.Alternate contact details if applicable: PermissionsConsent*I understand that the Camp 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 authorise this, I hereby give my general consent to any necessary medical treatment and authorise the Scouter in charge of the camp to sign any document required by the hospital authorities. I agreeConsent*I give permission for my Scout/Explorer to undertake various scouting activities at this event I agreeMedicationsLeaders are allowed to provide non-prescription medicines provided we have parental consent, those 16 or over can make this decision themselves. Therefore, as part of our first aid provision at the above camp please indicate which of the following over the counter medicines may be used if requested for your child. Aftersun Antihistamine Antiseptics Calpol Ibuprofen Insect repellent Paracetamol Plasters Sting / Bite Releif Suncream Any prescription medicines currently being taken by the participant should be notified separately. When they are brought to the event, they should be appropriately packed, and have instructions as to the administration. Whilst it is common for many to self-administer some medication, inhalers etc., it is important that the leadership team is aware and if possible have spares of some medications, inhalers, Epipen’s etc.Parent / Carer Name* Parent / Carer Signature*Parent / Carer email address*To receive a copy of this form. This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.CommentsThis field is for validation purposes and should be left unchanged.
