Parent/Guardian Consent Form

 

 

 

Youth’s Name:                                                                                                      Phone:                             

Address:                                                                                                                  City:                             

Province:                                                                                                      Postal Code:                             

Parent/Guardian Name:                                                                                                   

 

Experience has shown that in connection with Scouting activities there are times when illness or accident may occur and immediate surgical or medical attention is necessary. This is my permission for the Leader in charge, or designate, to make arrangements for qualified surgical or medical attention for my child/ward in the event of an emergency without necessity of my prior approval. I understand that I will be notified by the quickest means possible if this authority is exercised.

 

In case of emergency please notify:

Name:                                                                                                                  Phone:                             

Address:                                                                                                                  City:                             

Province:                                                                                                      Postal Code:                             

 

If you will be absent from your normal place of residence during the period when the event is being held, please indicate where you can be contacted:

Name:                                                                                                                  Phone:                             

Address:                                                                                                                  City:                             

Province:                                                                                                      Postal Code:                             

 

Permission to participate:

I, the undersigned, after having read, understood and completed the above, hereby give my permission for my child/ward to attend and participate in:

 

q     the following event/activity:                                                                                                                    

q     at the following location:                                                                                                                        

q     on the following date:                                                                                                                            

 

I have reviewed the information on my child’s/ward’s physical fitness form and confirm that the information is up to date.

 

 

 

Signed, Parent/Guardian:                                                                                         Date: