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Young Person Information Form
Young Person Information Form
Please complete the form below and select witch section the form needs to be sent to:
First name:
Surname:
Email address:
Date Of Birth:
Gender:
Male
Female
Other
Prefer not to Say
Section:
Squirrels
Beavers
Cubs
Scouts
Explorers
Contact Details:-
Primary Contact 1
First Name:
Surname:
Address 1:
Address 2:
Address 3:
Post Code:
Email Address:
Mobile Phone Number:
Landline Number:
Primary Contact 2
First Name:
Surname:
Address 1:
Address 2:
Address 3:
Post Code:
Email Address:
Mobile Phone Number:
Landline Number:
Emergency Contact:
First Name:
Surname:
Address 1:
Address 2:
Address 3:
Post Code:
Email Address:
Mobile :
Landline:
Relationship To Young Person:
Doctor's Surgery
Name Of Doctor:
Surgery Name:
Address 1:
Address 2:
Address 3:
Post Code:
Phone Number:
NHS Number:
Essential Information
Medical Details:
Allergies:
Dietary Requirements:
Tetnus (Year of last Jab):
Swimmer:
YES
NO
Disabilities:
Develepmental
Injury
Physical
Medical
Mental Health
Progressive
Sensory
Religion or Faith:
Buddhist
Christian (all denominations)
Hindu
Jewish
Muslim
Sikh
Any other Religion or Faith
NO Religion
School or College:
Gift Aid:
YES
NO
Consents
Photographs (select those that apply):
ALL
All Except Press
No Social Media or Press
Internal Only
The Scout Association Media
Sensitive Information:
YES
NO
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