TROOP 9 INFO SHEET 

Name__________________________ Birthday__________ 

Parents/Guardians___________________________________________  

Address______________________________________________________

Insurance & Policy#____________________________________________

Hospital_______________________  Doctor________________________  

Any and all allergies to anything___________________________________

_____________________________________________________________

Can we assist with over the counter meds_________________________ __

Special things to watch_________________________________________

____________________________________________________________

Three Separate Emergency Contact People

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_____________________________________________________________

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Signature____________________________  Date____________________