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Truro St George's Scout Troop Permission to Camp & Health Form
Some or all of the information given may be put onto a computer for use by the Scout Association only.
Indicates required field
Name of child
Childs National Health Service Number
Date of Birth
Name of Parent/Gaurdian
Alternative Telephone Number
Relationship to Young Person
Parent/Guardians Address During the Event
Date of last Tetanus injection
Doctors Telephone Number
The Leader I/C (or in their absence one of the assistant leaders) may administer the appropriate minor treatment/precautions (as listed below ) if required.
Paracetomol / Anadin
Cuts & Grazes -
Wash with water and apply a plaster or appropriate dressing
BurnEze Spray (Minor Burns where skin is not broken only)
Anthisan Bite and Sting
In the space below please give details of the following:-
Any Known Infectious Diseases with which Your Child (named overleaf) has been in contact within the last three weeks (e.g. Chicken Pox, Diphtheria, Measles, Mumps, Rubella, Whooping Cough etc.)
Any special dietary needs or items to avoid.
Any Known Allergies/Sensitivities/Disabilities and details of any known precautions or remedies (e.g. Penicillin, Food Colourings, Travel Sickness, Bed-wetting, Asthma etc.)
Details of any Medicines/Diets/Treatments currently being Taken/Followed (including dosage details) & the Specialist and Hospital concerned if appropriate (please include any non prescription preparations, such as cough sweets , herbal medicines).
If He/She has to take any Medicine's, the bottle(s), jar(s) or other items should be clearly labelled with their name and the exact dosages, and should be handed to the Leader i/c before Departure.
Digital Signature which confirms your acceptance (type your name here)
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18th Truro (St George's) Sea Scout Group
Registered Charity Number:
Boscawen Park, Truro, Cornwall, TR1 1SG -