Shooting Consent Form
BUNGLE-EE 2013
JOIN THE SCI-FI A D VEN TURE
Written parental consent is needed before a young person can take part in this activity.
Activity: 0.177 cal. Air Riffle Target Shooting
This activity forms part of the 2013 Bungle-ee camp and is an optional base for those in the Scout Section
and above. Trained members of the Squirrel Wood Service Crew will run the base on Saturday 6 July 2013;
it will not involve shooting at anything other standard target radials.
Please read the statement below before signing the consent and declaration slip
THE FIRE ARMS ACT 1968, SECTION 21: Prohibits the possession of a firearm and ammunition (under any circumstances), by any
person who has been convicted of a crime and sentenced to a term of imprisonment (or its equivalent for a young person) of 3 months
or more. The prohibition applies in all circumstances, including handling and firing at an approved shooting club or at a clay pigeon
shoot where a certificate is not ordinarily required. It also applies to the possession or use of other categories of firearms and
ammunition such as AIRGUNS or shotgun cartridges for which a certificate is not needed. A sentence of 3 months to 3 years attracts a
5 year prohibition, shorter ones no prohibition but a longer one means a life ban.
Please note that without the completed consent form your child will not be able to take part in this activity
base.
"
Parent or Guardian’s consent and declaration
(*please delete were applicable)
*
I, being the person named below (if over 18) or parent/guardian of the person named below (if under 18),
*
declare that I / he / she is not subject to restriction by virtue of the regulations set out in Section 21 of the
Firearms Act 1968 and give permission for:
Name of person:
Age:
,to take part in the
0.177cal. AIR RIFFLE TARGET SHOOTING BASE AS PART OF BUNGLE-EE 2013.
•
Please state if he/she has a disability or medical condition relevant to this activity:
•
Please indicate details of any medical treatment they are receiving at the moment:
Name:
Address:
Signature:
Date:
Post Code:
For Squirrel Wood use
Group details:
Pass Number Issued:
Doncaster Danum Scout District
District Headquarters: 35 Arksey Lane, Bentley, Doncaster, South Yorkshire DN5 0RX
Tel +44 (0)300 111 2018 email [email protected] web www.doncasterscouts.org.uk
Patron HM The Queen President HRH The Duke of Kent Founder Robert Baden-Powell OM Chief Scout Lt Cdr (Hon) Bear Grylls RN
Incorporated by the Royal Charter. Charity No. 524729