National Capital Area Council
YOUTH PERMISSION FORM
Firearms, Treat, Activity, Release of Minor, Photo
The following signatures are required for Scouts\Varsity\Sea Scouts\Venturers\
Explorers to fully participate.
One form per youth participant required.
MINOR'S NAME (Please print):
Unit#:
_
PERMISSION TO TREAT
In case of emergency, I understand every effort will be made to contact me (if participant is an adult, my
spouse or next of kin). In the event I cannot be reached, I hereby give my permission to the licensed healthcare
practitioner selected by the adult leader in charge to secure proper treatment, including hospitalization,
anesthesia, surgery, or injections of medication for my child (or for me, if participant is an adult).
Signature of parent/guardian or adult: Date:
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PARENTAL FIREARMS PERMISSION AND RELEASE
U.S. Federal Law prohibits any person from furnishing, loaning or otherwise providing a minor any firearm
or live ammunition without the express permission of their parent or guardian. Your son/daughter will not
be allowed on the shooting range without the following signed release. If you do not wish your
son/daughter to participate in shooting activities please write "NO PERMISSION".
MINOR'S NAME (Please print):
I
(Please
print)
The
Parent
Legal Guardian
of the
above named minor do hereby give permission as required by Federal Code 18 U.S.C. Chapter 44, et. seq.
to the Boy Scouts of America, National Capital Area Council, and to instructors certified by the National
Capital Area Council meeting the requirements for instructors established by the Boy Scouts of America
(National), to furnish a firearm, BB Gun, .22 Rifle, 20 gauge shotgun, 12-gauge shotgun, .22 handgun
(Venturers\Sea Scouts\Explorers only), and ammunition to said minor for the purpose of instructing him/her
in the safe handling of firearms, safe shooting and marksmanship.
I do further agree to indemnify and save harmless the Boy Scouts of America, National Capital Area
Council and all officers, members, employees, and volunteers thereof, from all suits or actions brought
for, or on account of, any injuries or damages received or sustained by any person or persons by or from
the consequences of any negligence or any act or omission of the above named minor occurring during
the course of said instruction.
Date Permission Granted: From To
_
Signed: The Parent\Legal Guardian _
Print full name: Date:
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Please turn the page over for more permission signatures