1. For office use only
URN ……………………….
REGISTRATION FORM
A form must be submitted for every camper attending. Leaders need only complete the personal and Scouting
/Guiding details and sign the declaration on the reverse. This will be held by the Administration Office and
the information will be treated as confidential. If there are any alterations to the details given below, these
must be notified to the Camp Administration, in writing (by parent/guardian if camper is under 18 years old),
prior to the camper’s arrival on site.
Please complete with ball-point pen in block capitals. Delete starred (*) items as appropriate.
PERSONAL DETAILS
Surname/family name: ................................................ First Names: ............................................................
Home Address: ................................................................................................................................................
..........................................................................................................................................................................
Country:................................................................. Post/ Zip Code: ................................................................
Telephone Number: ............................................... Date of Birth: ...................................................................
Nationality: .........................................…………... Religion: .............................................. Male/Female*
SCOUTING / GUIDING / DETAILS
Troop/Unit* Name :............................................................ Scout/Guide/Leader Appointment: .........................
District: ....................................................................... County: .........................................................................
Troop SwEng Dutch
PERMISSION TO CAMP(to be completed by parent/guardian)
I give permission for my Son/Daughter/Ward* (insert name) ............................................................ to take
part in the Kent Scout International Jamboree 2009 at Shaw’s Camp Site, Cudham from 30 July to 6th August
2009 and to take part in all the activities unless specified on the reverse of this form, such activities being
subject to availability.
Signed (Parent/Guardian*): .................................................. ………………………………………………….
Print Name .....................................................……………… Date ………………………………………….
IMPORTANT – PLEASE COMPLETE THE REVERSE OF THIS FORM

2. ACTIVITIES AUTHORISATION (to be completed by Parent)
A full and varied range of activities will be provided and run in accordance with The Scout
Association’s Safety Rules. A list of these is available within the enclosed information or from the web
site KIJ09.ORG.UK
If you DO NOT wish you son/daughter to take part in the following specific activities, please tick below
Shooting [ ] Archery [ ]
Please enter below any other activities from which he/she is prohibited -
………………………………………………………………………………………………………….
………………………………………………………………………………………………………….
Is he/she able to swim 50 metres and stay afloat for 5 minutes in light clothing. YES / NO*
No responsibility for the personal equipment/clothing and effects can be accepted by the organisers and
The Scout Association does not provide automatic insurance cover in respect of such items.
Signed (parent/guardian*) …………………………………………………………………………….
Print Name …………………………………………………………………………………………….
(*delete as appropriate)
CRB DISCLOSURE (To be completed by leaders)
In signing this section you declare that you currently hold a CRB Disclosure (or ANI / DS) that is less
than 5 years old and agree to the information being checked at Scout/Guide Headquarters.
Scout/Guide Association Membership Number ………………………………………………..............
Signed ............................................................................................. Date ................................................
Print Name.................................................................................................................................................
Photograph and Video Recording
Photographs and video recordings taken at Scouting events in Kent may be used for Scouting purposes.
i.e. on internet, printed material (including the press) and presentations. Attendance at such events will
automatically be deemed as permission given to re-produce the images.
Please return the completed form to your group leader together
with 4 passport size photographs with name clearly printed on
back of each photograph no later than .....................(date to be entered locally)