Chaos Summer Camp - participant information

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Date of Camp: Fri 15 to Wed 20 Aug

Location: Butchers Coppice Scout Camp and Activity Centre, Holloway Avenue, Bournemouth BH11 9JW.

Information Pack: Download the information pack

Cost: £280 plus £20 cash for the mini Explorer Belt

Activities: including rifle shooting, paddlesports and silent disco, and trips to Brownsea Island, Splashdown and the New Forest Aqua Park. You can also get a taste of what an explorer belt expedition is like on the Mini Explorer Belt Expedition, where you'll be given challenges to complete by hiking and using public transport to get around the South of Hampshire.

Find out more information here: https://bit.ly/HEATsummercamp
Download the information pack

All information is stored in line with our privacy policy.

Email *

The person attending is a *

Explorer Scout

Adult Volunteer

Name of participant *

Which District are you from? *

Participant mobile number *

Please enter in format 07123 456789 - this will be used during the event if needed e.g. When they are on the mini explorer belt or activities.

Can we add this to WhatsApp *

Yes

Date of Birth *

YYYY

Gender *

Male

Female

Other:

Address including postcode *

Emergency Contact 1 and relationship *

E.g. Joe Bloggs (Mother)

Emergency Contact 1 phone number *

Please enter in format 07123 456789

Emergency Contact 2 and relationship

E.g. Joe Bloggs (Mother)

Emergency Contact 2 phone number

Please enter in format 07123 456789

Doctor name/Surgery *

Any medical conditions or allergies *

Please put details under other

Other:

Any medication? *

Dose, timings and if they need reminders

Other:

Dietary requirements *

Other:

Any additional needs *

Other:

Can the following medications be given *

Please tick those that can be given. Any allergies should be listed above.

Paracetamol

Ibruprofen

Allergy relief

Diarrhoea relief

Hydrocortisone Cream (Insect bites)

Required

Can the participant take part in air rifle shooting? *

Under 18: I, being the parent/guardian of the person named above, declare that he/she is not subject to restriction by virtue of Section 21 of the Firearms Act 1968 (which applies only to persons who have served a term of imprisonment or youth custody)

Over 18: I declare I am not subject to restriction by virtue of Section 21 of the Firearms Act 1968 (which applies only to persons who have served a term of imprisonment or youth custody)

Yes

Other:

Consent to attend (under 18) *

I confirm that I have parental responsibility for the participant. They are in good health and I agree to them attending the events. I acknowledge the need for obedience and responsible behaviour on their part and that the Leaders reserve the right to send any participant home. I give permission for the leaders to seek medical help in the event of any emergency. In the event I cannot be contacted, I give general consent to the treatment (including the use of anaesthetics) advised by the medical authorities and give my permission for a leader to sign any forms required. Note: the Medical Authorities can insist on parental authority before treatment commences. I agree to the data protection statement above.

Yes

Other:

Photo consent *

Photos and videos taken at this event will only be used for Hampshire Scouts Media and Marketing purposes. This includes the Hampshire Scouts website and Hampshire Scouts social media including (but not limited too): Instagram, YouTube, TikTok and Twitter (X).

Yes

Comments or questions

If you are just attending part of the camp or arriving late/leaving early, please indicate that here.

None

Other:

Clear selection

A copy of your responses will be emailed to the address you provided.

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