Sherbrooke Forest District

HEALTH FORM

This form must be filled in no earlier than the day of
the camp and must be brought to the camp.

Any medicines and tablets required must be clearly labeled
with the Cub Scout’s name and handed to Akela, with the
full written instructions of the time and the dose required.

Name of Cub Scout

   

Pack

   
     

Medications:

   
     
     

Medicines and tablets may not be brought to the camp
without the written consent of parents or guardians.

Every care will be taken for the health, comfort and safety of your
child but no responsibility can be taken for any accident or illness,
which may occur.

If your child is prone to headaches or minor ailments e.g. Overtiredness,
sore throats etc., and you would normally give a pain relief tablet, the First
Aid Kit will stock Disprin and Panadol.



Please fill in below your preference for your child to be given and in what circumstance:

Disprin

dosage

 

Circumstances

 

Panadol

dosage

 

Circumstances

 

This is to certify that to the best of my knowledge _____________________ has not been in
contact with any infectious disease during the last 3 weeks and to the best of my knowledge,is in good health
.

 

Parent / Guardian  ___________________________

Dated       __________________