Members Form - 17th Nene (The Hamptons) Scout Group

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Young Person Details

* Indicates required field

Squirrel Scout Name *

First

Last

Date of Birth *

Address (Line 1) *

Address (Line 2) *

Address (Line 3) *

Post Code *

Primary Contact 1

Name *

First

Last

Relation to Young Person *

Address (if different to Young Person) *

Email Address *

Phone Number *

Primary Contact 2

Name *

First

Last

Relation to Young Person *

Address (if different to Young Person) *

Email *

Phone Number *

Essential Information

Medical Details *

Allergies & Dietary requirements *

Special Needs (including physical and learning difficulties) *

Education Setting *

School (Reception Year) School (Nursery) Nursery or Pre-School Childminder No setting

I give permission for photos of my child to be used by 17th Nene (The Hamptons) Scout Group, including being published on our Scout Group's website and our private and public Facebook pages. *

Yes No

Are you intending to stay with your young person at Squirrel Scouts? *

Yes No Unsure

Are you willing to take part on a Parent Rota? *

Yes No

Submit