Fall Cub Family Adventures Camp
October 17 - 19, 2014
Scouts and parents will spend two nights and days with many other families from North Texas.

Please fill out Medical History COMPLETELY

Please check ALL that apply and explain below regarding medications needed or physical limitations due to any medical conditions, attach additional information if needed.

By submitting credit card information below, you are agreeing and accepting the following terms and the amount checked above:

Parent Authorization: This health history is correct as far as I know and the persons herein described have permission to engage in all prescribed activities, except as noted by the physicians and/or myself. I will register any medication taken by my son(s) and /or his adult partner with the health official at the camp. In the event I cannot be reached in an emergency, I hereby give permission to the physician selected by the camp health official and/or leader in charge to secure proper hospitalization, anesthesia, medications, and/or surgery for my son and the adult partner.

I hereby consent to the use of voice, photograph, and/or video in the news coverage, moviemaking, or similar projects approved by the Boy Scouts of America for all persons named on this form.

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