PERMISSION TO CAMP FORM
/Registered Charity No 303399
Kent Scouts
20th to 21st January 2018Kent Scouts Gold Expedition Training
Name: ...... ……………. District: ...…...... …......Address: ...... ……………...... ………......
Own Mobile No: …………………………………………………………………….. Post Code: ...... ….....
Email Address: ………………………………...... …...... Date of Birth: ......
eDofE number: ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
Bronze DofE Completed Yes / No Silver DofE Completed Yes / No .
Previous hill walking experience: ...... ……......
Date of last tetanus injection: ...... ……...... Blood Group if known: ......
Name, address & tel no of GP: …………………………………………………………………………………..…..……….
…………………………………………...... ……....…......
My payment of £______will pay cash on the day / has been made by bank transfer (delete as applicable).
Declaration (All Course Members to sign):
I am in a fit condition to undertake this strenuous course and I will be able to provide myself with the equipment listed. I will inform the staff of any relevant medical problems (eg asthma, food allergies, etc).
Please give details overleaf, tick here (…..) if you have.
Signed: ...... ………...... National Health Service No.: ......
Over 18’s, please give next of kin details here: ……….…………………………………………………………………….
………………………………………………………………….…………………………………………………………...…….
Parents Authorisation (Required for all those under 18):
I give my permission for my son/daughter to take part in the Gold/QSA Expedition Training Course centred at Hopehill Scout Campsite, Meopham, Kent.
Should it become necessary for my son/daughter to receive medical treatment and I cannot be contacted to Authorise this, I hereby authorise the Leader in charge, on my behalf, to give consent for any anaesthetic and/or medical treatment to be given and to sign any document required by the medical authorities. Photographs may be taken at the event and used on Scouting materials and social media. Please indicate if there is a reason for your child not to be in any photographs. ………………..
Signed Parent/Guardian: ...... ………………………...... Date: …...... ………..…..
Name (Printed): ...... ……………………………………………………………………………………………....
This is how I can be contacted during the course: Tel no: …………...……… Mobile No: …………………………..
Additional Info: ...... ………
Troop/Unit Leaders Authorisation (Required for all Explorer Scouts)
I consider the above Scout to be able enough to cope with the demands of the Course, I will ensure that basic training is undertaken and that adequate equipment will be provided. I understand that it is my responsibility to check through the kit, as listed, and to ensure the candidate is properly equipped.
Signed: ...... Name (Printed): ...... ……..……. Appointment: ......