Download and complete the following form with your physician:

BSA Medical Form (Parts A-B-C) PLUS Ten Mile River Form

BE SURE TO CHECK THE FOLLOWING:

• Is there a physician’s signature?
• Is the Physician’s evaluation and advice section filled out?
• Has the physical examination been done within the last 12 months?
• Are the name, address and emergency contact information completely accurate?
• Is the form signed by the parent of anyone under the age of 18?
• Are all the immunization lines filled out with dates of shots clearly indicated?
• Are all the communicable disease lines filled out?
• Has the parent or applicant filled out the health history section, with serious health conditions noted?
• Did I attach a photocopy of both sides of my insurance card?