GP: TEL: ADDRESS: POSTCODE: NHS NUMBER: MEDICAL CONDITIONS/MEDICATION:
SPECIAL NEEDS (DIET/EDUCATIONAL) OR ALLERGIES:
PLEASE READ THE FOLLOWING STATEMENTS BEFORE SIGNING: I ACCEPT THAT THE UNIT WILL BE EEPING INFORMATION ABOUT MY CHILDS MEMBERSHIP AND I UNDERSTAND IT WILL BE USED FOR SCOUTING PURPOSES ONLY. IF IT BECOMES NECESSARY FOR MY CHILD TO RECEIVE MEDICAL TREATMENT AND I CANNOT BE CONTACTED BY ANY MEANS TO AUTHORISE THIS* I HEREBY GIVE MY GENERAL CONSENT AND AUTHORISE THE LEADER IN CHARGE TO SIGN ANY DOCUMENT REQUIRED BY THE HOSPITAL.