Troop 2 Member Quick Reference Card
All information provided will be held
in confidence, and is required to ensure we can contact you in an emergency and
take care of your son during events.
Contact Information
Name
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Date of
Birth
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Address
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Telephone
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Email(s)
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Parent
Names
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Parent
Telephone
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Any
custodial restrictions or alternate contacts?
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Parent
Employer Name
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Medical Information
Health
Insurance Carrier
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Policy
Number
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Primary
Care Physician
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Address
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Telephone
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Allergies
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Special
Considerations (critical physical and
medical history, medications, asthma, foods, etc)
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Notes
Please let
us know if YOU have any questions or concerns
|
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Permission
to transport, photograph, post photos on the web, etc (please note any
restrictions)
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