NOTE: WHEN COMPLETED THE INFORMATION ON THIS FORM WILL BE HELD IN CONFIDENCE PARENTAL CONSENT FORM ~ARMY CADET FORCE CERTIFICATE FOR ATTENDING ACTIVITIES Number Rank First name ‘Surname Detachment County | Devon | Date of Birth Male/Female Address details Ser | Startdate | End date Activity Location | 1] saps nye oumny ane = | 2 [fletzs |eholeS |acs wee | amples. Consent by Parent/Guardian 1. I wish for the above named cadet to be considered for acceptance on the activities listed above. 2. — |understand that acceptance for the activities will be subject to the complete discretion of the ACF Cadet Commandant or CCF Contingent Commander. 3. | certify to the best of my knowledge that the above named cadet is fit to attend and that al the information on this form is accurate and up to date. The cadet is not suffering from an infectious disease’ and has not been in contact with any case of infectious disease during the previous 3 weeks. 4, _Lunderstand that withholding essential medical information may prevent the cadet from attending unit activities. (Please note whilst minor ailments can be dealt with anything that prevents them from taking part in the activities may require them to be collected and taken home) 5. authorise the ACF Commandant (or in their absence the senior of his representatives present) to ive permission for the above narried cadet to receive emergency medical care# 6. | understand that if the cadet is unable to carry on with activities then | may have to collect them from the activity Signature. Date. NAME. Relationship to Cadet. + Infectious diseases eg measles etc 2Every affort will be made to contact you for your consent should the cadet need to receive any emergency dental, medical or surgical treatment (including anaesthetic) as considered necessary. However it may not always be possible NOTE: WHEN COMPLETED THE INFORMATION ON THIS FORM WILL BE HELD IN CONFIDENCE 1NOTE: WHEN COMPLETED THE INFORMATION ON THIS FORM WILL BE HELD IN CONFIDENCE Your contact details 7. You or your representative must be available at all times while the cadet is on the activity. Parent/Guardian’s details Alternative next of kin details Name Name Relation Relation to to Cadet Cadet Phone SDE Phone number Address Address GP's details Practice Se Doctor's name Phone TE ba Address t Medical details 8 Ifthe above named cadet suffers from any medical condition, the training staff must be made ‘aware of it to allow the correct precautions and actions to be taken. Answering the following questions will assist with this. Vaccinations ‘Question. ‘Answer Remarks Are the cadets childhood immunisations up to date*? weet Date of anti-tetanus? ® In ine with current DoH guidelines on childhood immunisation schedule ~ https JAvwrw. gov.uk/governmenticollections/immunisation NOTE: WHEN COMPLETED THE INFORMATION ON THIS FORM WILL BE HELD IN CONFIDENCE 2NOTE: WHEN COMPLETED THE INFORMATION ON THIS FORM WILL BE HELD IN CONFIDENCE Medical conditions 9. Does the cadet suffer from any of the below conditions? Please delete as appropriate. Condition Answer _ Remarks: Asthma Yes | No ‘Chest complaints Yes | No ‘Wheezing or hay fever Yes | No Migraine Yes / No Fits Yes | No Faints, Yes | No = 1 Bad period pains Yes | No Nervous disorders Yes | No Any other (provide details) Yes / No Medical treatment 10. If the cadet is currently undergoing any medical treatment (including taking medication‘) please complete the information below. ‘i Remarks (including frequency of Ser Condition Treatment ihadioatont 1 2 3 4 5 ‘Any medication that's to be handed into the Cadet Force Staff should be clearly marked with name and full instructions. NOTE: WHEN COMPLETED THE INFORMATION ON THIS FORM WILL BE HELD IN CONFIDENCE 3NOTE: WHEN COMPLETED THE INFORMATION ON THIS FORM WILL BE HELD IN CONFIDENCE Over the counter medication 14. The following over the counter medication may be available if required. Please indicate which may be used for the above named cadet. Condition ‘Answer Remarks Plasters Yes | No | Skin and scalp symptoms Yes 1 No 9 Bite and sting creams | Eye and Mouth Symptoms Yes | No eg Eye drops and Sore throat tablets Coughs Colds and Flu : Yes | No eg Double action pain relief or Ibuprofen (pain relief and anti-inflammatory Stomach Symptoms og Travel sickness (tablets) and sickness? | Y°* ' N° bloating ‘Allergy/Hayfover Yes | No ‘egAntichistamine (tablets) Bowel Symptoms Yes | No ‘eg abdominal cramps, acute diarrhooa } Pain symptoms Yes 1 No ‘eg Paracotamol or Ibruprofen Sunscreen Yes | No ‘Aftersun Yes | No NOTE: WHEN COMPLETED THE INFORMATION ON THIS FORM WILL BE HELD IN CONFIDENCE 4NOTE: WHEN COMPLETED THE INFORMATION ON THIS FORM WILL BE HELD IN CONFIDENCE Dietary requirements 12. Any dietary requirement for our cadets can only be catered for if they are known in advance of the activity; please list any requirements below Ser Requirement Remarks NOTE: WHEN COMPLETED THE INFORMATION ON THIS FORM WILL BE HELD IN CONFIDENCE 5OFFICIAL SENSITIVE