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    Application Form Health Examination Form Parents Consent Form

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    april rose cataina
    This document contains an application form, health examination form, and parents consent form for a Girl Scouts patrol leadership training camp. The forms collect personal information like name and contact details, medical history, and permission from a parent for their daughter to attend the training from August 31st to September 1st, 2018 at North Central School in Santiago City. The parent agrees to not hold the Girl Scouts responsible for any incidents beyond their control and provides 1000 pesos for snacks and meals.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Application Form Health Examination Form Parents Consent Form

    Uploaded by

    april rose cataina
    61 views1 page
    This document contains an application form, health examination form, and parents consent form for a Girl Scouts patrol leadership training camp. The forms collect personal information like name and contact details, medical history, and permission from a parent for their daughter to attend the training from August 31st to September 1st, 2018 at North Central School in Santiago City. The parent agrees to not hold the Girl Scouts responsible for any incidents beyond their control and provides 1000 pesos for snacks and meals.

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    parental consent

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    This document contains an application form, health examination form, and parents consent form for a Girl Scouts patrol leadership training camp. The forms collect personal information like name and contact details, medical history, and permission from a parent for their daughter to attend the training from August 31st to September 1st, 2018 at North Central School in Santiago City. The parent agrees to not hold the Girl Scouts responsible for any incidents beyond their control and provides 1000 pesos for snacks and meals.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    61 views1 page

    Application Form Health Examination Form Parents Consent Form

    Uploaded by

    april rose cataina
    This document contains an application form, health examination form, and parents consent form for a Girl Scouts patrol leadership training camp. The forms collect personal information like name and contact details, medical history, and permission from a parent for their daughter to attend the training from August 31st to September 1st, 2018 at North Central School in Santiago City. The parent agrees to not hold the Girl Scouts responsible for any incidents beyond their control and provides 1000 pesos for snacks and meals.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 1

    APPLICATION FORM HEALTH EXAMINATION FORM PARENTS CONSENT FORM

    SCHOOL____________________________________ Name :_______________________________


    To Whom It May Concern
    PERSONAL DATA
    Health History: (Check giving approximate dates)
    1. Name:_______________________________ This is to permit my daughter to participate
    2. Date of Birth:_________________________ Frequent Coids:________________________
    in the PATROL LEADERSHIP TRAINING OF THE GIRLS
    3. Home Address: _______________________ Kidney Trouble:________________________
    SCOUT OF THE PHIL. held at NORTH CENTRAL
    ____________________________________ Chickenpox:__________________________
    SCHOOL Santiago City on AUG, 31-SEPT, 1,2018.
    4. Mobile Number:_______________________ Abscessed Ears:_______________________
    5. Parent/Guardian:______________________ - Convulsion:___________________________
    ____________________________________ Mumps:______________________________
    We will not hold the Girls Scouts of the
    6. Person to notify in case of Emergency Fainting:_____________________________
    Philippines responsible for any untoward incident
    Name:_______________________________ Sleep Walking:________________________
    that may happen beyond their control.
    Address:_____________________________ Whooping Coughs:_____________________
    ____________________________________ Frequent Sore Throat:__________________
    1,000.00 pesos (snacks and meals)
    7. Religious Affiliation:____________________ Measles:_____________________________
    8. Food Prohibition:______________________ Heart Trouble:_________________________
    Bronchitis:____________________________
    SCOUTING DATA Stomach Upsets:_______________________
    1. Program Level:________ Troop No._______ Rheumatic Fever:______________________
    2. Date of Last Registration:_______________ Constipation:_________________________
    3. Camping Experience Tuberculosis:__________________________
    District/School:_______________________ Operations of Serious Injuries:____________
    Allergic Reactions:_____________________ Parent/Guardian
    Provincial Camp:______________________
    Penicillin: ____________________________ (Signature over printed name)
    Regional Camp:_______________________

    Other Drugs:___________________
    IMPORTANT: Please notify the Council if this
    ____________________________________ applicant is exposed to any communicable diseases
    Signature of Applicant 3 weeks
    Poor to trip attendance

    ____________________________________
    Name of Field Adviser/School Coordinator Licensed Physician

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