Joining Form

Personal Details

Name

Gender

Date of Birth
Contact Details

Address

Postcode

Telephone Number

Mobile Number

Email Address

Doctors Details

Doctors Name

Surgery Name

Surgery Telephone Number

National Health No.

Special Needs

Do you have any dietary, medical or other needs? (Please include any allergies and medications)

Emergency Contact Details

Name

Address

Postcode

Telephone Number

Mobile Number

Relationship to you

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Just a few more questions...

Are you already involved in Scouting?

Do you know your membership number?

Membership Number

Which District are you in?

How would you like to pay your yearly subscriptions?

How would you like to pay your yearly subscriptions?

I agree to these records being kept electronically solely for the purpose of scouting, no information will be passed to any third party. I agree to photographs of myself being used in publicity for the scout association. I agree to pay yearly subscriptions, and acknowledge that these may change from year to year. I will be notified of such changes.

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Welcome to NOMADS!

You are now a fully signed up NOMADS member! Lets mark this occasion with a photo!
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.