28th Cambridge Scout Group
Activity Permission Form Please return to a leader by ………………………… with the balance of activity fees. I give permission for ………………………………………………………………………… (name of scout/cub/beaver) to attend …………………………………………………………………………………………… (name of activity) on………………………………………………………………………………………………………… (date) During the activity, I can be contacted on (please give telephone numbers and times):       My scout/cub/beaver’s Doctor’s details are (name, address of surgery, contact number):       My scout/cub/beaver is currently taking the following medication (if none, say none):       My scout/cub/beaver suffers from (please give details of any general medical complaints e.g. asthma; if none, say none):       Within the last 3 weeks, my scout/cub/beaver has come into contact with the following infectious diseases (if none, say none):       Date of last anti-tetanus injection: ………………………………………………………………………… The following medications are currently held in the troop first aid kit. Please delete those which you do not give the leadership permission to administer if necessary: Paracetamol Anti-histamine cream Burneze Waspeze Suncream Aftersun Immodium Please delete any of the following which due to allergies, intolerances, religious or moral grounds your scout/cub/beaver WILL NOT eat. Meat Fish Other Seafood Dairy Products Nuts Gluten Please detail any further food allergies or intolerances below:       My scout/cub/beaver can / cannot (delete as appropriate) swim 50m and tread water My scout/cub/beaver has / has not (delete as appropriate) got permission to swim under careful supervision. My scout/cub/beaver has / has not (delete as appropriate) got permission to take part in water activities. I give permission for the above undeleted medications to be administered by a warranted leader. If it becomes necessary for my scout/cub/beaver to receive medical treatment, and it is not possible to contact me for my specific consent, I give my general permission for any necessary medical treatment, and authorise the scouter in charge of the camp to sign on my behalf any form required by the hospital authorities in the case that a medical practitioner deems the delay required to obtain my signature unwise. I understand the activity leadership reserve the right to send any participant home. Signed: …………………………………………………………… Date: …………………………………… Print Name: ………………………………… Relationship to scout/cub/beaver: ……………………….