BSA Health Forms

1. Page 1 

   1. Youth legal names should be used.  Feel free to put a nickname in parentheses.

   2. It must be signed and dated. A signature of a legal guardian is required for participants under the age of 18

   3. Scouts of any age need to sign it, too.

   4. Please initial near the box that indicates if there are any limitations.

2. Page 2 

   1. Your Unit Leader is the ScoutMaster / Crew Advisor or CubMaster

   2. Your council name is "Mayflower"

   3. Ensure you include the Health Insurance company(s) and Policy number(s)

   4. Health History... please be honest. If your scout has a medical issue that the adults should be made aware of it is in the best interest of your child to inform them.  They are left in the care of these adults who want to ensure they're caring for their health and safety as well as providing a fun event.  This form would also be passed on to medical staff like an EMT or hospital in case of emergency.  The more accurate the better medical care your child will receive.

3. Page 3

   1. The medication list must include all medications and supplements (including vitamins), even if they are purchased over the counter. Include anything taken occasionally or as needed.

   2. Under the medication grid, there is a spot to check "Yes" or "No" in response to the question "Non-prescription medication administration is authorized with these exceptions:____".  Any form with a missing signature will be returned for correction.

      1. Please consider this carefully. Here is a real-life example of what it means to check "No". If your child gets stung by a bee, the adults will be able to apply ice, if they have it. They can call an ambulance. They will NOT be able to provide an antihistamine or pain relief until after they have contacted you for your verbal approval. This can be very difficult on our outings with limited cell phone service.

   3. You can attach a copy of immunizations from your child's doctor's office and just right "See Attached" on the table for Immunizations.

For campouts longer than 72 hours, parts A, B, and C (4 pages total) are required.  This includes summer camps (Squanto), winter camps, and high adventure camps like Philmont and SeaBase.  Please include a copy of your health insurance card. No scout will be allowed to remain in camp without a health history that includes a parental signature giving permission to treat in an emergency.  The facility will require you to submit the health forms using their process.