1st Saintfield Scout Group
Registration Form 2010-2011
What Section were you in last year (please tick) ?
Beavers □ Cubs □ Scouts □ Explorers □ non-member □
What Section are you applying to join this year (please tick) ?
Beavers □ Cubs □ Scouts □ Explorers □
(NOTE: if you were a non-member last year, you will be placed on a waiting list and the Leader of the Section will contact you when a place is available)
Name______
Address______
______
Post Code______
Telephone: Home:______Mobile :______
E mail ______
(Please give us the best email address for us to use to let you know about events, time changes, etc.)PLEASE USE CAPITALS
DOB______Age______
Ethnic Origin: White / Chinese / Other Asian / Afro Caribbean / other
Religion:______
Parent/ Guardian contact details:
Contact 1: Name:______Mobile Number:______
Contact 2 Name:______Mobile Number:______
General Information
Does any of your family have hobbies, skills or interests that they would share with the Scout Group?
Please detail:______
Do you give permission for photographs and/or video to be taken of your child/ children on official Scout activities; these may be used for publicity in accordance with Scout Association guidelines. They may be used on our website
YES / NO
Do you agree to being included in a parent’s roster, to help occasionally at meetings or outings?
YES / NO
Do you agree to joining the Group Parent’s committee, if asked, to meet 4 or 5 times a year to support the Scout Group?
YES / NO
Name of Parent who can help:______
Have you completed an Access NI (Police check) form?
YES / NO
Have you signed a Gift Aid form?
YES / NO
Signed______Parent / Guardian
Date ______
Data Protection:
Information supplied on this form may be held on computer to be used by 1st Saintfield Scout Group and the Scout Association for administration purposes.
Photographs It is the policy of The Scout Association to safeguard the welfare of all members by protecting them from physical, sexual and emotional harm. It is essential that anyone creating a website follows a few simple guidelines designed to ensure the personal safety of young people. We do not want our sites to be used as a method for people with evil intentions to develop contacts with children.
Sometimes photos and video images of Scouts taking part in activities are submitted to the local newspapers, the Group, District or County newsletters and website or put on. If you have any objections please indicate that you are not willing for your child’s image to used in this way by ticking the appropriate box.
Health Details (these will be treated as confidential)
Name______D O B______
Beavers □ Cubs □ Scouts □ Explorers □
HEALTH
§ Does your child have any health problems eg asthma, epilepsy, allergies?
YES / NO
(If YES please give brief details on page 4 of this form and discuss with the Section Leader)
§ Will your child require medication during outings or meetings?
YES / NO
(If YES please give brief details on page 4 of this form and discuss with the Section Leader. We will require written consent to administer medication.)
§ Does your child have learning, physical, sensory or other difficulties?
YES / NO
(If YES please give brief details on page 4 of this form and discuss with the Section Leader how we can best help)
Signed: ______Parent/Guardian
Date:______
1st Saintfield Scout Group
Health Details (these will be treated as confidential)
Does your child suffer from any of the following conditions? YES/NO
Autism
Asperger's syndrome
Dyslexia
Dyspraxia
ADHD/ADD - attention deficit hyperactivity disorder / attention deficit disorder
ODD - oppositional defiant disorder
CD - conduct disorder
OCD - obsessive compulsive disorder
If the answer to any of the above questions is yes please inform the leader in charge of that section, these do not stop young people from joining but leaders must know about them.
Please tick next to the condition/s that applies.
Signed
Print your name
Relationship with young person
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