Apex Challenge : Next Event

Apex Overnight Challenge: May 2008

This form is designed to be printed out and completed by hand. It is to be filled in and signed by a parent/guardian, but if the entrant is 18 or over he/she can fill it in personally. It must be brought to the registration at the event.
PLEASE STAPLE BOTH PAGES TOGETHER,

The Apex Extreme takes place from Saturday 10th to Sunday 11th May 2008. It is being held at Sherwood Pines
Forest Park near Mansfield. The starting area is close to the main entrance, OS grid reference SK 612647. It may
include activities such as rock climbing, assault courses, shooting and canoeing. All will be run by suitably qualified and
experienced instructors. The event opens from 6:00pm on Saturday 10th May and will finish by 11:00am on Sunday
11th May. I agree to my child taking part in the above competition and understand that the Apex Challenge organisers
reserve the right to send any participants home if necessary.
Some photos and video of Scouts taking part in the competition may be used for displays, Scouting magazines, newsletters, articles in local newspapers, the Apex Challenge website, or general promotion of the competition. If you object to your child's image being used in this way, please submit your written request to Apex Challenge, 2 Roman Place, Leeds, LS8 2DS to arrive before the date of the competition.

Personal Details:

Scout's Name:

Date of Birth:

Team Name:

Scout Group:

Medical Details:

Doctor's Name:

Doctor's Telephone No.:

Doctor's Address:

My child's NHS number is:

My child has the following allergies:

My child's last anti-tetanus immunisation was on:

My child needs the following medication:
(Please give details of what it is and whether your child can administer it themselves. Please clearly label it with his/her name and dosage details.)

During the 21 days prior to the Apex Challenge, my child has come into contact with the following infectious diseases:

My child can swim 50 metres unaided, tread water, and may bathe under careful supervision: (YES/NO)

The event may include an air rifle shooting activity. This will be led by a qualified instructor. I declare that my child 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) and give permission for my child to take part in such an activity: (YES/NO)

My child has the following special dietary needs:

My child also has these other special needs:

Emergency Contact Details:

If it becomes necessary for my child to receive medical treatment and I cannot be contacted by telephone or any other means necessary to authorise this, I hereby give my general consent to any necessary medical treatment and authorise the Scout leader in charge of the competition to sign any document required by the hospital authorities, which may or may not include forms giving permission for a general anaesthetic.

During the Apex Overnight Challenge please contact in case of emergency:

Name:

Relationship to Scout:

Address:

Telephone Number(s):

Signed:
(MUST BE Parent/Guardian if under 18):

Date:

For more information visit www.apexchallenge.co.uk

Note: The medical profession takes the view that the parent's consent to medical treatment cannot be delegated. This view is explicit in the Children's Act 1989. Thus medical consent forms have no legal status and a doctor/nurse insisting on the consent of a parent to a particular treatment has the right to do so. For this reason the organisers of the Apex Challenge cannot insist on parents/guardians signing the statement above. However, it can be a comfort to medical staff to have general consent in advance from parents or to have a Scout Leader on hand able to sign forms required by medical authorities.