Health and Safety Forms

 

SAFETY & RISK MANAGEMENT     TRAVEL    YOUTH PROTECTION


MEDICAL & DISMISSAL FORMS


BSA ANNUAL MEDICAL FORM

This form replaces the Class 1, 2 and 3 forms for all short term and long term activities except the Jamboree and the three national high adventure bases. All old style forms prepared in 2009 will not be accepted as evidence of an annual physical examination in 2010. Forms are not kept on file from year to year. The form is updated on an annual basis for all youth and adults. 

Go to the FAQ page for the Annual Medical Form  at www.scouting.org for additional information.

ANNUAL MEDICAL FORM 34-605 (pdf)

USE PARTS A AND C FOR WEEKEND CAMPING

The annual medical form must be accompanied by the medical form appendix for the camp attended. These forms include the over the counter medication authorization and medication forms that must be signed by a licensed physician, and release forms for treatment at regional medical or urgent care centers that must be signed by parents. 

2010 MEDICAL FORM APPENDIX

A complete summer camp medical package will have the annual medical form plus this package to comply with state regulations for children's camps. A letter explaining the required signatures and a checklist is included.

OSR MEDICAL FORM APPENDIX  (pdf)

for Onteora Scout Reservation Home troop units, Council provisional troop, Counselor-in-training program, Webelos Bridge Camp, Bear Claw NYLT, Path to Eagle Camp and Camp staff.

SSR MEDICAL FORM APPENDIX (pdf) 

for Cub World and Schiff Scout Reservation Day Camp, Wauwepex Webelos Camp, Counselor-in-training program, Bear Claw NYLT and Camp staff.

SCOUTS WITH UNSIGNED OR INCOMPLETE FORMS WILL NOT BE ALLOWED TO STAY OVER AT CAMP.

 

DISMISSAL FORM

While we realize that the children intend to spend all week at camp, cases do arise where a child needs to be picked up during the week. Theodore Roosevelt Council BSA requires signed consent and compliance with dismissal procedures when early departure by a scout from a Cub Scout or Boy Scout program is required; when an adult other than a parent will pick up and transport the scout , and for all other situations as described on the form.

DISMISSAL FORM (pdf)

 

HIGH ADVENTURE TREKS @ PHILMONT SR, FLORIDA SEA BASE, & NORTHERN TIER

Philmont Scout Ranch and Florida Sea Base require the use of their special medical form by all youth and adults because of the strenuous nature of the activities taking place there.

It is recommended that unit leaders have a complete medical history and permission slip for every participant attending each Scouting activity. The medical history form and permission slip, in most cases, will allow emergency medical treatment to a youth member in case of injury or illness when a parent or guardian cannot be contacted.

Philmont Medical Form: To obtain the proper medical forms, call Philmont at 505-376-2281 and ask for Camping or PTC Headquaters.

Florida Sea Base Medical Form (pdf)


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