Registration (Youth)

OSG Youth Registration Form

Please complete one form for each scout who will be participating in 7th Trailblazers. All youth scouts must be registered in order to participate in group meetings or events.

Child's Name(Required)

First Last

Preferred Pronouns(Required)

Grade

Birthdate(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Parent/Guardian Info

Parent/Guardian #1(Required)

First Last

Email(Required)

Phone(Required)

Same Address?(Required)

Same as Child

Different Address

Address(Required)

Street Address Address Line 2 City State ZIP Code

Parent/Guardian #2 (if applicable)

First Last

Email

Phone

Same Address?

Same as Child

Different Address

Address

Street Address Address Line 2 City State ZIP Code

Emergency Contacts

Please provide contact information for a family member or close friend that can be an emergency contact in the event that the parents/guardians listed above are not reachable. This person cannot be one of the parents listed above. This person will only be contacted if the parents listed above do not respond and the scout requires emergency medical care or it is over 30 minutes past the expected end of the event/meeting.

Emergency Contact(Required)

First Last

Phone(Required)

Emergency Contact #2

First Last

Phone

Authorized Pickups

Please list all other individuals authorized to pick up child. Unless otherwise specified, it is assumed that the listed parents/guardians and emergency contacts are authorized for pick up.

Authorized Pickups

Medical Information

Current Medications

Allergies or Dietary Needs

Medical or Mobility Considerations

Special Needs of Behavioral Considerations

Other Information We Should Know

Authorized Medications

What medications are the leaders authorized to give your scout?(Required)

Please check off which of the following over-the-counter medications you are comfortable with the leaders dispensing to your child if needed. The leaders keep these medications with the group’s first aid kit. Please note that other over-the-counter topical creams may be applied, as needed, should a first aid situation arise. Such topical creams include Neosporin, burn cream, and anti-itch cream.

Advil (Ibuprofen)

Tylenol (Acetaminophen)

Benedryl (Diphenhydramine)

Zyrtec (Cetirizine HCl)

Claritin (Loratadine)

Tums (Calcium Carbonate)

None – Always call me first.

OSG Youth Registration Form

Parent/Guardian Info

Emergency Contacts

Authorized Pickups

Medical Information

Authorized Medications

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