1st SWINDON SEA SCOUTS

Membership Information

This form is important, please complete and return to your Section Leader.

All information given below is treated as confidential and is only for use by 1^st Swindon Sea Scouts and shall not be passed to any third party.

Full Name of Young Person ………………………………………………………………………………………………………

Address……………………………………………………………………………………………………………………………

Post Code……….…………………………. ……………. Tel. No. (incl. code)…………………………….………

Date of Birth……………………………………………… National Health No………………………………….…

He/She* has/has not* received the normal pre-school boosters to cover tetanus.

Swimming standard:-  Non-Swimmer / Novice (Red) / Intermediate (Blue) / Advanced (Gold)*

Parent/Guardian’s Name (1)…………………………… Occupation.………………………………………….

Address if different from above…………………………..……………………………………………………………………..

Tel. No. (day)…………………………………………….. Tel. No. (evening)…………………………………….

Tel. No. (mobile)…………………………………………………

Parent/Guardian’s Name (2)……………………………… Occupation….………………………………………

Address if different from above…………………………………………………………………………………………………

Tel. No. (day)……………………………………………. Tel. No. (evening)……………………………………

Tel. No. (mobile)…………………………………………

Doctors Name…………………………………………… Tel. No………………………………………………

Surgery address……………………………………………………………………………………………………………….

Details of any allergies/sensitivities or medical conditions (e.g. penicillin, paracetamol, elastoplast, asthma, etc.)

……………………………………………………………………………………………………………………………….

Details of any long term medication (e.g. inhalers for asthma, insulin, etc.)

……………………………………………………………………………………………………………………………….

Any other information that may be required for the protection of the Young Persons health, safety and welfare.

……………………………………………………………………………………………………………………………….

In the event of an illness or accident requiring emergency hospital treatment I authorise the leader in charge to sign on my behalf, any written form of consent required by the hospital authorities if the delay required to obtain my own signature is considered inadvisable by the doctor or surgeon concerned**.

Signed………………………………………………………………………………………………  Date ……………………………………………………….

From time to time, we will have events that we would like to publicise, either in the Wick on notice boards or local papers. Please give your permission for us or another representative of our group to take pictures and allow them to publicised. We will ensure that the source is reputable and that the photos are used under our strict guidance. Likewise other parents may want to take group photos which hopefully you will not object to either.

Signed …………………………………………………………………………………………………… Date…………………………………………………………..

Our group is always trying to reduce the amount of paper we distribute; please can you let us have your email address, so we can send you newsletters and other information via email. Emails are always put onto blind copy distributions, as a result the only person who sees your email is group executive member. However all group members have agreed in principle not too forward any chain mails or use our group addresses in anyway apart from group information.

Email address ……………………………………………………………………………………………

*delete as required

**Note. The medical profession takes the view that the parent’s consent to medical treatment cannot be delegated. This view is explicit in the Child Act 1989. Thus medical consent forms have no legal status and a doctor/nurse insisting on the consent of a parent to particular treatment has the right to do so. For this reason we do not insist on parents signing the above statement (and may, therefore, cross through the statement before signing this form). However, it can be a comfort to medical staff to have general consent in advance from parents or to have a Leader on hand able to sign forms required by medical authorities.