Activity Information and Parental Permission Form – Shooting
Written
parental permission is needed before a young person can take part in this activity
Upper section to be completed by Leader.
Lower section
to be filled in by parent or guardian and returned to Leader.
Name of Unit or Section: BEAVERS - CUBS - SCOUTS - EXPLORERS (circle section
Activity Information:
Air rifle shooting
Date or period Spring Term Commencing 1.1.13
Administrative Information:
Start Time ________________________ Finish Time _______________
Place:
4th Littlehampton Scout Group HQ BN17 9BHAdditional information
Information on shooting dates will be updated on the programme
pages
Emergency contact telephone No._____________________________________________________
Leader:
________________________ Contact details:
If any additional information is required please do not hesitate to contact the Leader of the activity.
Parent or Guardian's consent
I, being the parent/guardian of the person named below, 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)
and give permission for:
______________________________________________(name of young person)
To take part in Air Rifle Target Shooting
Please state if he/she has a disability or medical condition relevant to this activity:
________________________________________________________________
Please indicate details of any medical treatment they are receiving at the moment:
_______________________________________________________________
Contact details in the event of an emergency:
______________________________________________________________
Tel: ___________________________
Name____________________Signature_____________________Date_______