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Fill Out Your Bsa 680 001 Form

The BSA 680 001 form serves as an essential document that captures informed consent, health history, and authorization for participation in various Scouting activities. It is critical for ensuring the safety and well-being of participants, as it outlines potential risks and medical requirements associated with high-adventure programs. If you need to fill out this form, please click the button below.

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Article Structure

The BSA 680 001 form serves a crucial role in the Boy Scouts of America (BSA) high-adventure programs. At its core, it is designed to ensure that participants—whether youth or adults—understand the inherent risks associated with various outdoor activities while also outlining necessary medical information and emergency protocols. This form includes several parts, starting with an informed consent section where participants acknowledge the physical and emotional challenges they may face. It asks for basic personal details such as the participant's name, date of birth, and expedition or crew number. Furthermore, the form addresses medical authorization, permitting designated individuals, like medical providers and adult leaders, to act in emergencies. This part also obligates participants to provide crucial health information, including any medical history or conditions that could impact their ability to safely engage in activities. Another significant aspect of the form is the pre-participation physical examination, which requires confirmation from a licensed healthcare professional that the individual is fit to participate in high-adventure activities. This medical clearance also addresses issues such as medication management and immunizations—all vital for participant safety and well-being. The BSA 680 001 form, therefore, functions not only as a waiver and consent document but also as a comprehensive health record and emergency guideline, crucial for the smooth operation of scouting adventures.

Bsa 680 001 Example

Part A: Informed Consent, Release Agreement, and Authorization

Full name: ___________________________________________

Date of birth: _________________________________________

High-adventure base participants:

Expedition/crew No.: _______________________________________________

or staff position:___________________________________________________

Informed Consent, Release Agreement, and Authorization

I understand that participation in Scouting activities involves the risk of personal injury, including death, due to the physical, mental, and emotional challenges in the activities offered. Information about those activities may be obtained from the venue, activity coordinators, or your local council. I also understand that participation in these activities is entirely voluntary and requires participants to follow instructions and abide by all applicable rules and the standards of conduct.

In case of an emergency involving me or my child, I understand that efforts will be made to contact the individual listed as the emergency contact person by the medical provider and/or adult leader. In the event that this person cannot be reached, permission is hereby given to the medical provider selected by the adult leader in charge to secure proper treatment, including hospitalization, anesthesia, surgery, or injections of medication for me or my child. Medical providers are authorized to disclose protected health information to the adult in charge, camp medical staff, camp management, and/or any physician or health-care provider involved in providing medical care to the participant. Protected Health Information/Confidential Health Information (PHI/CHI) under the Standards for Privacy of Individually Identifiable Health Information, 45 C.F.R. §§160.103, 164.501, etc. seq., as amended from time to time, includes examination findings, test results, and treatment provided for purposes of medical evaluation of the participant, follow-up and communication with the participant’s parents or guardian, and/or determination of the participant’s ability to continue in the program activities.

(If applicable) I have carefully considered the risk involved and hereby give my informed consent for my child to participate in all activities offered in the program. I further authorize the sharing of the information on this form with any BSA volunteers or professionals who need to know of medical conditions that may require special consideration in conducting Scouting activities.

With appreciation of the dangers and risks associated with programs and activities, on my own behalf and/or on behalf of my child, I hereby fully and completely release and waive any and all claims for personal injury, death, or loss that may arise against the Boy Scouts of America, the local council, the activity coordinators, and all employees, volunteers, related parties, or other organizations associated with any program or activity.

I also hereby assign and grant to the local council and the Boy Scouts of America, as well as their authorized representatives, the right and permission to use and publish the photographs/film/ videotapes/electronic representations and/or sound recordings made of me or my child at all Scouting activities, and I hereby release the Boy Scouts of America, the local council, the activity coordinators, and all employees, volunteers, related parties, or other organizations associated with the activity from any and all liability from such use and publication. I further authorize the reproduction, sale, copyright, exhibit, broadcast, electronic storage, and/or distribution of said photographs/film/videotapes/electronic representations and/or sound recordings without limitation at the discretion of the BSA, and I specifically waive any right to any compensation I may have for any of the foregoing.

Every person who furnishes any BB device to any minor, without the express or implied permission of the parent or legal guardian of the minor, is guilty of a misdemeanor. (California Penal Code

Section 19915[a]) My signature below on this form indicates my permission.

I give permission for my child to use a BB device. (Note: Not all events will include BB devices.)

Checking this box indicates you DO NOT want your child to use a BB device.

NOTE: Due to the nature of programs and activities, the Boy Scouts of America and local councils cannot continually monitor compliance of program participants or any limitations imposed upon them by parents or medical providers. However, so that leaders can be as familiar as possible with any limitations, list any restrictions imposed on a child participant in connection with programs or activities below.

List participant restrictions, if any: None

________________________________________________________

I understand that, if any information I/we have provided is found to be inaccurate, it may limit and/or eliminate the opportunity for participation in any event or activity. If I am participating at Philmont Scout Ranch, Philmont Training Center, Northern Tier, Sea Base, or the Summit Bechtel Reserve, I have also read and understand the supplemental risk advisories, including height and weight requirements and restrictions, and understand that the participant will not be allowed to participate in applicable high-adventure programs if those requirements are not met. The participant has permission to engage in all high-adventure activities described, except as specifically noted by me or the health-care provider. If the participant is under the age of 18, a parent or guardian’s signature is required.

Participant’s signature:____________________________________________________________________________________________ Date: ______________________________

Parent/guardian signature for youth: __________________________________________________________________________________ Date: ______________________________

(If participant is under the age of 18)

Complete this section for youth participants only:

Adults Authorized to Take Youth to and From Events:

You must designate at least one adult. Please include a phone number.

Name: _________________________________________________________________	Name: _________________________________________________________________
Phone: _________________________________________________________________	Phone: _________________________________________________________________

Adults NOT Authorized to Take Youth to and From Events:

Name: _________________________________________________________________	Name: _________________________________________________________________
Phone: _________________________________________________________________	Phone: _________________________________________________________________

680-001

2019 Printing

Part B1: General Information/Health History

Full name: ___________________________________________

Date of birth: _________________________________________

High-adventure base participants:

Expedition/crew No.: _______________________________________________

or staff position:___________________________________________________

Age: ____________________________ Gender: __________________________ Height (inches): ___________________________ Weight (lbs.): ____________________________

Address: _________________________________________________________________________________________________________________________________________

City: ___________________________________________State: ____________________________ ZIP code: __________________ Phone: ______________________________

Unit leader: ____________________________________________________________________________ Unit leader’s mobile #:_________________________________________

Council Name/No.: _______________________________________________________________________________________________________Unit No.: ____________________

Health/Accident Insurance Company: ________________________________________________________ Policy No.: ___________________________________________________

Please attach a photocopy of both sides of the insurance card. If you do not have medical insurance, enter “none” above.

In case of emergency, notify the person below:

Name:______________________________________________________________________________Relationship: ___________________________________________________

Address: _________________________________________________________________ Home phone: _________________________ Other phone: _________________________

Alternate contact name: _________________________________________________________________ Alternate’s phone: ______________________________________________

Health History

Do you currently have or have you ever been treated for any of the following?

Yes	No	Condition					Explain
		Diabetes	Last HbA1c percentage and date:				Insulin pump: Yes  No 

		Hypertension (high blood pressure)

		Adult or congenital heart disease/heart attack/chest pain (angina)/
		heart murmur/coronary artery disease. Any heart surgery or
		procedure. Explain all “yes” answers.

		Family history of heart disease or any sudden heart-related
		death of a family member before age 50.

		Stroke/TIA

		Asthma/reactive airway disease	Last attack date:

		Lung/respiratory disease

		COPD

		Ear/eyes/nose/sinus problems

		Muscular/skeletal condition/muscle or bone issues

		Head injury/concussion/TBI

		Altitude sickness

		Psychiatric/psychological or emotional difficulties

		Neurological/behavioral disorders

		Blood disorders/sickle cell disease

		Fainting spells and dizziness

		Kidney disease

		Seizures or epilepsy	Last seizure date:

		Abdominal/stomach/digestive problems

		Thyroid disease

		Skin issues


		Obstructive sleep apnea/sleep disorders	CPAP: Yes		No	

		List all surgeries and hospitalizations	Last surgery date:

		List any other medical conditions not covered above

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2019 Printing

Part B2: General Information/Health History

Full name: ___________________________________________

Date of birth: _________________________________________

High-adventure base participants:

Expedition/crew No.: _______________________________________________

or staff position:___________________________________________________

Allergies/Medications

DO YOU USE AN EPINEPHRINE YES  NO

AUTOINJECTOR? Exp. date (if yes) ___________________________

Are you allergic to or do you have any adverse reaction to any of the following?

Yes	No	Allergies or Reactions	Explain

Medication

Food

DO YOU USE AN ASTHMA RESCUE YES  NO

INHALER? Exp. date (if yes) ___________________________________

Yes	No	Allergies or Reactions	Explain

		Plants


		Insect bites/stings
		Insect bites/stings

List all medications currently used, including any over-the-counter medications.

Check here if no medications are routinely taken.

If additional space is needed, please list on a separate sheet and attach.

Medication

Dose

Frequency

Reason

 YES NO

Non-prescription medication administration is authorized with these exceptions: ________________________________________________________________

Administration of the above medications is approved for youth by:

_______________________________________________________________________ / _______________________________________________________________________

Parent/guardian signature

MD/DO, NP, or PA signature (if your state requires signature)

Bring enough medications in sufficient quantities and in the original containers. Make sure that they are NOT expired, including inhalers and EpiPens. You SHOULD NOT STOP taking any maintenance medication unless instructed to do so by your doctor.

Immunization

The following immunizations are recommended. Tetanus immunization is required and must have been received within the last 10 years. If you had the disease, check the disease column and list the date. If immunized, check yes and provide the year received.

Yes	No	Had Disease	Immunization	Date(s)

Tetanus

Pertussis

Diphtheria

Measles/mumps/rubella

Polio

Chicken Pox

Hepatitis A

Hepatitis B

Meningitis

Influenza

Other (i.e., HIB)

Exemption to immunizations (form required)

Please list any additional information about your medical history:

_________________________________________

DO NOT WRITE IN THIS BOX.

Review for camp or special activity.

Reviewed by: ___________________________________________

Date: _________________________________________________

Further approval required: Yes  No

Reason: _______________________________________________

Approved by:____________________________________________

Date: _________________________________________________

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2019 Printing

Part C: Pre-Participation Physical

This part must be completed by certified and licensed physicians (MD, DO), nurse practitioners, or physician assistants.

Full name: ___________________________________________

Date of birth: _________________________________________

High-adventure base participants:

Expedition/crew No.: _______________________________________________

or staff position:___________________________________________________

You are being asked to certify that this individual has no contraindication for participation in a Scouting experience. For individuals who will be attending a high-adventure program, including one of the national high-adventure bases, please refer to the supplemental information on the following pages or the form provided by your patient. You can also visit www.scouting.org/health-and-safety/ahmr to view this information online.

Please fill in the following information:

Yes

Explain

Medical restrictions to participate

Yes

Allergies or Reactions

Explain

Yes

Allergies or Reactions

Explain

Medication

Plants

Food

Insect bites/stings

Height (inches)

Weight (lbs.)

BMI

Blood Pressure

Pulse

Normal

Abnormal

Explain Abnormalities

Examiner’s Certification

I certify that I have reviewed the health history and examined this person and find

no contraindications for

Eyes

participation in a Scouting experience. This participant (with noted restrictions):

True

False

Explain

Ears/nose/throat

Meets height/weight requirements.

Lungs

Has no uncontrolled heart disease, lung disease, or hypertension.

Has not had an orthopedic injury, musculoskeletal problems, or orthopedic

Heart

surgery in the last six months or possesses a letter of clearance from his or her

orthopedic surgeon or treating physician.

Has no uncontrolled psychiatric disorders.

Abdomen

Has had no seizures in the last year.

Genitalia/hernia

Does not have poorly controlled diabetes.

If planning to scuba dive, does not have diabetes, asthma, or seizures.

Musculoskeletal

Examiner’s signature: _______________________________________ Date: _______________

Neurological

Examiner’s printed name: _________________________________________________________

Address: _______________________________________________________________________

Skin issues

City: ______________________________________State: ______________ ZIP code: _________

Other

Office phone:___________________________________________________

Height/Weight Restrictions

If you exceed the maximum weight for height as explained in the following chart and your planned high-adventure activity will take you more than 30 minutes away from an emergency vehicle/ accessible roadway, you may not be allowed to participate.

Maximum weight for height:

Height (inches)	Max. Weight		Height (inches)	Max. Weight	Height (inches)	Max. Weight		Height (inches)	Max. Weight

60	166	65		195	70	226	75		260

61	172	66		201	71	233	76		267

62	178	67		207	72	239	77		274

63	183	68		214	73	246	78		281

64	189	69		220	74	252		79 and over	295

680-001

2019 Printing

	High-Adventure Risk Advisory to	Summit Bechtel Reserve
	Health-Care Providers and Parents

	Phone: 304-465-2800 Website: www.summithighadventure.org

The Summit Bechtel Family National Scout Reserve requires that the following supplemental information be shared with the parents and/or guardians and examining health-care providers of every participant. Participants who cannot meet these guidelines will be sent home at their own expense.

The Summit. Activities at the Summit require a certain level of fitness and some can be very physically, mentally, and emotionally demanding. The programs can include mountain biking, BMX biking, skateboarding, rock climbing, zip lines, challenge courses, shooting, archery, whitewater rafting, and kayaking. Depending on the program(s) you select, you will need to arrive at the Summit physically prepared to participate in those activities. The average walk is 5–7 miles a day on uneven terrain with significant changes in elevation. The heat index often reaches almost 100 degrees in the summer. Be prepared!

It is recommended that every participant review information about the Summit Bechtel Reserve at www.summitbsa.org and learn about the program activities that have been selected for participation. Answers to many frequently asked questions can be found at the Summit website. Additional questions can be emailed to summit.program@scouting.org, or you may call 304-465-2800.

Allergy or Anaphylaxis. Participants who have had an anaphylactic reaction due to any cause MUST contact the Summit Bechtel Reserve before arrival. If you are allowed to participate, you will be required to have appropriate treatment with you. The individual and at least one other member of the group must know how to administer the treatment. If you do not bring appropriate treatment with you, you will be required to buy it before you will be allowed

to participate.

Asthma. Asthma must be well-controlled before participating. This means:

1)the use of a rescue inhaler (albuterol) less than two times per week (except

use for the prevention of exercise-induced asthma); 2) nighttime awakenings for asthma symptoms less than two times per month. Well-controlled asthma may include the use of long-acting bronchodilators, inhaled steroids, or oral medications such as Singulair. You may not be allowed to participate if: 1) you have asthma not controlled by medication; or 2) you have been hospitalized/gone to the emergency room to treat asthma in the past six months; or 3) you have needed treatment by oral steroids (prednisone) in the past six months. You must bring an ample supply of your medication and a spare rescue inhaler that are not expired. At least one other member of the crew should know how to use the rescue inhaler. Any person who has needed treatment for asthma in the past three years must carry a rescue inhaler on the trek. If you do not bring a rescue inhaler, you must buy one before you will be allowed to participate.

Immunizations. Each participant must have received a tetanus immunization within the last 10 years. Recognition will be given to participants who do not have a specific immunization because of philosophical, political, or religious beliefs. In such a situation, the Immunization Exemption Request form should be obtained by emailing summit.program@scouting.org.

Seizure Disorder. A seizure disorder or epilepsy does not exclude an individual from participation; however, the disorder must be well controlled with medication. A well-controlled disorder is one in which a year has passed without a seizure. Exceptions to this guideline may be considered on an individual basis.

Recent Musculoskeletal Injuries or

Orthopedic Surgery. Participants at the Summit will put a great deal of strain on their joints and skeletal structure. Individuals with significant musculoskeletal problems (including back problems) or orthopedic surgery within the last six months must have a letter of clearance from their treating physician to be considered for approval. These individuals should contact the Summit in advance for approval to participate.

Psychological and Emotional Difficulties.

Medications for these issues must never be stopped prior to or during participation at the Summit. Experience has demonstrated that these issues can be exacerbated when a participant is under stress from physical and mental challenges.

Diabetes. Both the individual with diabetes and one other person in the group must be able to recognize the signs and symptoms of high and low blood sugar. An insulin-dependent person who has been newly diagnosed or who has undergone a change in their delivery system must have a letter from their treating physician to participate. A recent HbA1c within the last six months is required for diabetic participants.

Hypertension (High Blood Pressure). High blood

pressure should be well controlled with medication. Medication should be continued as prescribed while participating at the Summit. Individuals should have a blood pressure of less than 140/90 to participate.

Medication. Each participant who needs medication must bring enough medicine for the duration of the trip, and that medicine must not have expired. Taking prescription medication is the responsibility of the individual taking the medication and/or that individual’s parent or guardian. A leader, after obtaining all the necessary information, can agree to accept responsibility for ensuring a youth takes necessary medication in accordance with the appropriate schedule. Medications should be secured in locked storage, according to National Camp Accreditation Program Standard HS-08, except for medications carried by the individual for emergent conditions (inhalers, EpiPens, etc.). Participants should consider bringing two or three supplies of vital medication. Participants with allergies that have resulted in severe reactions or anaphylaxis must bring an EpiPen that has not expired. Summit-supplied medications shall be administered and/or dispensed in accordance with preapproved medical procedures. Participants will be charged for maintenance medications not brought to the Summit that are supplied by the Summit Health Lodge.

680-001 October 2019

	High-Adventure Risk Advisory to	Summit Bechtel Reserve
	Health-Care Providers and Parents

	Phone: 304-465-2800 Website: www.summithighadventure.org

Recommendations for Chronic Illnesses.

Adults or youth with any of the following conditions should undergo an evaluation by a physician before considering participation at the Summit.

1.	Chest pain, myocardial infarction (heart attack), or family history of heart
	disease in any person before age 50
2.	Congestive heart failure
3.	Heart surgery, including angioplasty (balloon dilation), to treat blocked blood
	vessels or place stents
4.	Stroke or transient ischemic attacks (TIAs)
5.	High blood pressure
6.	Claudication (leg pain with exercise, caused by hardening of
	the arteries)

Participants age 21 and older who exceed the maximum acceptable weight limit for their height at the Summit medical recheck WILL NOT be permitted to participate in offsite high-adventure programming, but they will have the option of participating in onsite programming if it is available. Summit staff will use their judgment to determine whether those under age 21 who exceed the maximum acceptable weight for their height can participate. The Summit may accept up to 20 pounds over the maximum; however, such exceptions are not made automatically, and discussion with Summit staff in advance will be required by calling

304-465-2800. Please consult the individual program information for weight restrictions due to equipment.

Height/Weight Restrictions. If you exceed the maximum

weight for height as explained in the following chart and your planned high- adventure activity will take you more than 30 minutes away from an emergency vehicle/accessible roadway, you may not be allowed to participate.

7.	Diabetes
8.	Smoking
9.	Excessive weight

Physical exertion at the Summit could precipitate either a heart attack or a stroke in someone who is susceptible. Individuals with a history of any of the conditions listed above should consult their physician to see whether participating in vigorous activities like those at the Summit could exacerbate their condition.

Weight Limits. Weight limit guidelines are used because individuals who are overweight have a greater risk of heart disease, high blood pressure, stroke, altitude sickness, sleep problems, and injuries. These guidelines are for all

Height (inches)

Max. Weight

60166

61172

62178

63183

64189

65195

66201

67207

68214

69220

Height (inches)

Max. Weight

70226

71233

72239

73246

74252

75260

76267

77274

78281

79 and over

295

Scouting high-adventure activities. Each participant’s weight must be at or less than the maximum acceptable weight in the height/weight chart. Anyone exceeding the maximum weight for their height will require further review by the Summit.

Summit Approval. The staff and/or staff physicians reserve the right to deny participation of any individual on the basis of medical history and/or a physical examination. Each individual participant is subject to a medical recheck at the Summit if indicated.

680-001 October 2019

Get Bsa 680 001 PDF Form

Form Characteristics

Fact Name	Details
Purpose	The BSA 680-001 form serves as an informed consent, release agreement, and authorization for participants in Boy Scouts of America high-adventure programs.
Informed Consent	Participants acknowledge the inherent risks associated with outdoor activities, including potential injury or death, and voluntarily choose to participate.
Medical Authorization	The form allows selected adult leaders to secure medical treatment for participants in emergencies, even if the emergency contact is unreachable.
Health Information	Protected health information can be shared among adults involved in the participant's care to ensure safety during activities, per federal privacy regulations including the HIPAA.
Participant Age	If the participant is under 18 years old, both the youth’s signature and a parent or guardian’s signature are required for consent.
Photographic Release	Participants grant permission for the BSA to use photographs or recordings made during events and waive any rights to compensation.
State-Specific Law	In California, it is illegal to furnish a BB device to a minor without parental permission, as outlined in California Penal Code Section 19915(a).
Authority of Medical Professionals	Section C of the form must be filled out by licensed medical professionals, certifying that participants are fit for high-adventure activities.

Guidelines on Utilizing Bsa 680 001

Filling out the BSA 680-001 form involves several steps to ensure that all necessary information is accurately recorded. Gathering relevant information beforehand can facilitate the process. It is essential to complete all sections thoroughly, as incomplete forms may affect participation in Scouting activities.

Begin by entering your full name in the designated space.
Write your date of birth in the provided field.
Indicate high-adventure base participants with the expedition or crew number and staff position if applicable.
Read the informed consent, release agreement, and authorization section carefully.
Check the appropriate box regarding permission for your child to use a BB device, if applicable.
If there are any participant restrictions, list them in the designated area.
Provide the participant's signature and date.
If the participant is under 18, include the parent/guardian's signature and date.
Complete the section for adults authorized to take youth to and from events, including phone numbers.
List any adults not authorized to take youth to and from events, again including phone numbers.
Proceed to Part B1. Fill in your full name and date of birth.
Provide general information including age, gender, height, weight, address, city, state, ZIP code, phone number, unit leader's name and mobile number, council name/number, and unit number.
Input information regarding health and accident insurance, including the policy number and attach a photocopy of both sides of the insurance card.
Fill in emergency contact details for notification in case of an emergency.
Respond to health history questions by marking "yes" or "no" and providing explanations where needed.
Complete Part B2 by listing any allergies or medications used, and check the appropriate boxes for the asthma rescue inhaler and EpiPen.
Document any vaccinations received and list additional health history if necessary.
In Part C, provide the participant's details and have a certified medical professional complete the physical examination section.
Ensure that the examiner signs and dates the certification.

What You Should Know About This Form

What is the purpose of the BSA 680 001 form?

The BSA 680 001 form serves as a comprehensive documentation for individuals participating in high-adventure programs within the Boy Scouts of America. It includes informed consent, health history, emergency contact information, and authorization for medical treatment. The form ensures that participants and their guardians are fully aware of the associated risks and agree to adhere to the safety guidelines.

Who needs to complete the BSA 680 001 form?

All participants, including youth and adults, attending certain high-adventure events organized by the Boy Scouts of America must complete the BSA 680 001 form. Parents or guardians must sign on behalf of participants under the age of 18. Providing accurate information is essential for safety and compliance with event requirements.

What information do I need to provide in the health history section?

In the health history section, participants must disclose any current or past medical conditions, allergies, and medications they are taking. This section is crucial for ensuring the safety and well-being of participants during their activities. Additional details such as recent surgeries, health restrictions, and emergency contact details are also required to ensure prompt medical assistance if needed.

Can I participate if I have a medical condition?

Participation with a medical condition is possible, but it is subject to approval based on the nature and severity of the condition. Participants must provide a letter of clearance from their healthcare provider if they have had significant medical issues, such as recent surgeries or unstable health conditions. The event organizers will review this information to determine eligibility.

What should I do if my child has allergies?

If your child has allergies, you must indicate this on the BSA 680 001 form. It is important to specify the nature of the allergies and any required medications, such as an EpiPen. Additionally, be sure that both your child and another adult in the group understand how to administer any necessary treatments in case of an allergic reaction.

What happens if I provide inaccurate information on the form?

Providing inaccurate information can limit or eliminate a participant's opportunity to take part in events or activities. The Boy Scouts of America takes this matter seriously, so it’s essential to provide truthful and complete information to prevent any complications during participation or in an emergency situation.

How does the form manage medical information confidentiality?

The form includes provisions for the handling of Protected Health Information (PHI). While the medical information shared is essential for participant safety, it will be disclosed only to authorized individuals, such as medical staff and event organizers, to facilitate necessary medical treatment. All efforts will be made to protect the participant's privacy.

Common mistakes

Filling out the BSA 680 001 form can be overwhelming, and many individuals make mistakes that could jeopardize participation in activities. One common mistake is failing to provide complete and accurate information. This includes not only personal details but also critical medical history. Incomplete sections may lead to misunderstandings regarding safety and health needs during participation.

Another frequent error is not disclosing existing medical conditions. If participants have chronic illnesses such as asthma or diabetes, these must be clearly noted in the health history section. Omitting this information can prevent the medical staff from delivering appropriate care. In emergencies, every detail counts.

Furthermore, individuals often neglect to provide proper emergency contact information. It's essential to list someone who is reachable and can make decisions in case of an emergency. Failure to do this may delay necessary medical responses. Participants should also ensure that the provided contacts are fully aware of their responsibilities.

Many people also overlook ensuring that their insurance information is accurate and up-to-date. An expired or incorrect policy number could complicate access to medical care. This simple oversight can have serious implications in emergencies.

Additionally, individuals may forget to check restrictions imposed by parents or healthcare providers. Listing any limitations is crucial for the safety of the participant. Ignoring this can result in inappropriate activities being assigned or participation being denied.

It's also important for participants to sign all necessary sections of the form. Often, the absence of a signature, especially from a parent or guardian for youth participants, can render the form invalid. This validation is essential for the legality of the consent provided.

Finally, participants frequently fail to bring a copy of their insurance card as requested. This documentation is necessary for smooth processing and access to care. Being mindful of these details can significantly enhance the safety and enjoyment of the scouting experience.

Documents used along the form

The BSA 680 001 form is crucial for participants in Scouting activities. However, there are several other forms that can accompany it, each serving an important purpose. Here’s a list of those essential documents.

Health History Form: This document gathers detailed medical information about the participant. It covers existing conditions, medications, and allergies to ensure a safe experience.
Emergency Contact Information: Essential for emergencies, this form provides contact details of a designated person who can be approached if issues arise during the event.
Photograph Release Form: This form allows the BSA to use photos taken during activities for promotional purposes. It gives consent for capturing and publishing images of participants.
Medical Release Authorization: This permits medical personnel to provide treatment in emergencies. It authorizes healthcare providers to share important medical information with responsible leaders.
Behavioral Expectations Agreement: Participants and guardians must sign this document, acknowledging the standards of conduct expected during events, which promotes a safe and respectful environment.
Permission Slip for Overnight Events: Required for events involving overnight stays, this slip grants permission for youth to stay away from home and outlines the details of the trip.
Personal Gear Checklist: This list helps participants pack necessary items for the trip, ensuring they arrive prepared with everything needed for a successful experience.
Immunization Records: Proof of immunizations is vital, as certain activities require up-to-date vaccinations. This document confirms the participant's immunization status.
Release of Liability Form: By signing this form, participants acknowledge the potential risks associated with activities and waive certain legal rights to claim against the organization.

Each of these forms plays a significant role in ensuring a positive and secure experience for everyone involved. When undertaking any adventure, proper documentation is key to focusing on what truly matters—enjoying the experience!

Similar forms

The BSA 680 001 form serves a critical role in ensuring the safety and readiness of participants in Boy Scouts activities. Several other documents share similar purposes in terms of consent, medical disclosures, and liability waivers. Here are seven documents that are comparable to the BSA 680 001 form:

General Medical Release Form: This document authorizes medical treatment for minors and includes detailed health history information. Like the BSA 680 001 form, it ensures that emergency medical personnel can act quickly if needed.
Activity Permission Slip: Parents or guardians sign this slip to grant permission for their child to participate. It typically includes acknowledgments of risks, paralleling aspects of informed consent found in the BSA 680 001 form.
Liability Waiver: Similar to the BSA 680 001 form, a liability waiver protects organizations against claims related to injuries. Participants acknowledge that they understand the risks associated with activities.
Health History Form: This document collects detailed personal health information. Like the BSA 680 001 form’s health history section, it assists organizers in identifying any medical conditions that may affect a participant's ability to engage in activities.
Emergency Contact Information Form: This form captures crucial emergency contact details. It ensures that there is a plan for communication in case of emergencies, mirroring the emergency contact element of the BSA 680 001 form.
Informed Consent Form: Often used in medical or research contexts, this form outlines risks and benefits. It requires a signature from participants or guardians, akin to the informed consent section in the BSA 680 001 form.
Photograph Release Form: This document secures consent for using images of participants. It parallels the BSA 680 001 form’s provisions for the use and publication of photographs taken during activities.

These documents collectively aim to ensure that participants, especially minors, are well-protected and that their rights and health information are respected during organized activities.

Dos and Don'ts

When completing the BSA 680 001 form, certain guidelines should be followed to ensure that the process goes smoothly. Below is a list of things you should and shouldn’t do when filling out this important document.

Do provide accurate and complete information regarding your and your child’s health history, including any medical conditions or medications.
Do ensure that all signatures are obtained, particularly from parents or guardians if the participant is under 18.
Do attach a photocopy of the insurance card, ensuring that all insurance details are up-to-date.
Do review the specific guidelines related to the high-adventure activities to confirm physical readiness.
Do keep a copy of the completed form for your records, in case any questions arise later.

Don’t skip any sections, as incomplete forms may delay participation in activities.
Don’t provide vague answers or leave any questions unanswered; clarity is crucial.
Don’t assume that verbal consent is sufficient; all permissions must be documented in writing on the form.
Don’t forget to check expiration dates on any medications, including inhalers and EpiPens; they must be current.
Don’t wait until the last minute to submit the form; early submission is best to address any issues that may arise.

Misconceptions

1. Misconception: The BSA 680 001 form is just a liability waiver. Many people believe this form is only about waiving liability, but it also includes critical health history information, consent for medical treatment, and permissions related to photography. It serves multiple purposes beyond just legal protection.

2. Misconception: Participants must disclose every health issue. While the form requires disclosure of serious medical conditions, it does not demand details about every minor health issue. The emphasis is on significant or ongoing health concerns that could affect participation.

3. Misconception: Signing the form means a child can participate in any activity. This is not true. The form highlights that all participation is subject to safety guidelines. It’s essential that participants meet specific health and fitness requirements for certain activities, especially high-adventure ones.

4. Misconception: Parents are not involved once the form is signed. After signing, parents remain integral to the process. They must ensure health information is accurate and that their child understands any restrictions or requirements related to participation.

5. Misconception: The form guarantees safety during activities. Many mistakenly think the form protects against all risks. While it acknowledges potential dangers and involves a waiver, it does not eliminate risks associated with physical activities. Participants should always be prepared for challenges.

6. Misconception: The Boy Scouts of America (BSA) can monitor all participant compliance with restrictions. Participants and parents might assume that BSA staff can continuously monitor health conditions or restrictions. In reality, leaders can’t constantly supervise every participant's adherence to their limitations or health requirements.

7. Misconception: Emergency contact information is optional. Some believe that providing an emergency contact is not critical. However, accurate contact details are vital in emergencies. If the primary contact cannot be reached, having additional contacts ensures prompt medical decisions can be made.

Key takeaways

Prioritize Informed Consent: Ensure all participants and guardians understand the risks involved in Scouting activities, and that they provide written consent acknowledging these risks.
Accurate Information is Essential: All health history, emergency contacts, and insurance details must be complete and accurate to ensure safety and appropriate response during emergencies.
Follow Medical Guidelines: Participants must meet health requirements, including those for high-adventure activities, and must have proper medical documentation as specified.
Review Participation Restrictions: Parents and guardians are urged to disclose any medical conditions or restrictions for their child. This is critical for the safety and enjoyment of all participants.

Browse Other Templates

Usa Draft - It highlights the importance of awareness in complying with federal requirements.

Jv 180 - Addresses of parents or guardians may also be kept confidential if desired.

Vs-35 - The Vs 35 form is used to file a Complaint Report regarding vehicle safety issues.