Health Information Form - Group Summer Camp 2016

Health Information Form

Camp /Night Away Location: Tawd Vale Scout Camp, Lowry Hill Lane, Lathom, Lancs, L40 5UL

Date(s): Saturday 23 July 2016 to Friday 29th July 2016 (Beavers 23rd-24th / Cubs 23rd-26th)

Camp / Night Away Leader in Charge: Andrew Pickersgill (Hawkeye)

Additional Leaders/Helpers Attending: Steve, Annette, Pol, Tommy, Alison, Ian, Sue, Carla, Lucy, Alex, Lezleigh, Kev

The section below should be completed by the Parent or Guardian of the young person named below. Please answer all of the following questions as fully as possible. As in the event of your child requiring emergency treatment, it will help the medical authorities in deciding which is the most appropriate treatment to give.

The Camp / Nights Away Leader (or in their absence one of the assistant leaders named above) may administer the appropriate minor treatment/precautions (as listed below) if required (please select the treatments below only if you agree with them being administered to your child where appropriate to do so).

Disclaimer: If it becomes necessary for the above named young person to receive medical treatment and I cannot be contacted to authorise this, I hereby give my general consent to any necessary medical treatment and authorise the Leader in Charge to sign any document required by the hospital authorities. I have provided all of my child’s medical information and my child is fit to participate in the camp / night away.

I will inform the Camp / Night Away Leader if any of the information given on this form changes before the event takes place.