Activity Information Form
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Billericay & Wickford
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Event:
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Fireworks Thriftwood
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Date:
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2nd November 2016
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Location:
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Thriftwood Camp Site Orchard Ave, Brentwood, CM13 2DP
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Meeting place and time:
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Thriftwood Camp Site 6.00 / 6.15 pm
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Collection place and time:
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Thriftwood Camp Site 8pm
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Cost:
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£4 children £5 Adults
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Transport details:
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Own transport
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Wear / Bring:
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Cub Uniform – and suitable clothing
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Further details:
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Organiser and contact details:
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Graham Pavitt – 01277 623353
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Contact details during the event:
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Graham Pavitt
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Please keep this section for your own information, and detach and return the section below.
Note: All activities will be run in accordance with The Scout Association’s safety Rules. No responsibility for the personal equipment/clothing and effects can be accepted by the organisers and The Scout Association does not provide automatic insurance cover in respect to such items.
Please complete and return this section to Your Leader by 19th October 2016
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Name of young person:
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D.o.B:
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Event:
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Fireworks Thriftwood
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I enclose a cheque / cash for £4.00/£5.00 (please makes cheques payable to 5th Billericay Cherokee Cub Scouts)
I have noted the arrangements above and agree to the named young person taking part.
Is he/she able to swim 50 metres and stay afloat for five minutes in light clothing?
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Yes / No
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Emergency contact:
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Phone:
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Doctor’s name and contact details:
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Details of any medications currently being taken:
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Details of any disabilities, conditions, allergies, special needs or cultural needs that might affect this activity:
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Details of any infectious diseases he/she has been in contact with in the last three weeks:
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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.
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Signed:
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Date:
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Relationship to young person:
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Please use the back of this form if more space is required
Note: The medical profession takes the view that the parent’s/carer’s consent to medical treatment cannot be delegated. This view is explicit in The Children’s Act 1989. Thus, medical consent forms have no legal status and a doctor or nurse insisting on the consent of a parent/carer to a particular treatment has the right to do so.
For this reason we do not recommend that Leaders insist on parents/carers signing the statement above. However, it can be a comfort to medical staff to have general consent in advance from parents/carers or to have a Leader on hand able to sign forms required by medical authorities.
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Cherokee Cubs 
