2. Personal Health and Medical Record Form Class 3:
Any person, youth or adult, staying overnight at Camp Alexander MUST have a completed Medical Form on file with the Health Lodge. This is the only form that we can accept please see the Medical Form Cover Sheet listed below. When arriving at camp this form and all medications should accompany the Scout to the Campsite where a medical re-check will be done. Please check this form before coming to make sure that the Doctor and the Parents or Guardian signature is complete. This form should be copied and given to each Scout to have filled out. This form will not be returned to you, please make copies if you need to before Camp.

3. HIPAA Medical Records Authorization/Permission Form Under 18 years of age
This form is needed to meet the new HIPAA Federal Regulations. There are two forms on this page copy cut in half and give one to each Scout. Please attach to the Medical form of each Scout.

4. HIPAA medical Records Authorization/Permission Form 18 years of age and older
This form is needed to meet the new HIPAA Federal Regulations. There are two forms on this page copy cut in half and give on to each adult. Please attach to the Medical form of each adult.

5. Roster: (Return with Final payment April 30, 2004)
This formMUST be filled out completely by each unit attending camp. Please fill out and mail with your unit’s final payments due April 30, 2004. Many units like to create their own rosters and that is acceptable as long as OUR FORMAT is followed. Your cooperation is appreciated in advance. Please note that at least one adult leader in each campsite must be BSA Youth Protection trained. Place a “Y” after each adult name that has this training prior to camp. Please make 3 copies of this ROSTER, as the original and 1 copy will be kept by the Camp and not returned.

6. State of Colorado Adult Leaders Form
This form must be filled out completely by each adult attending Camp. Please make as many copies as needed. These forms will be collected at check in.

7. Swim Classifications:
Please read this form completely and select your option. There is an attached sheet that has places in Colorado Springs where swim checks can be done for those units who live in the area and those from out of the area units who want to spend an extra day in Colorado Springs. You do not have to live at 5000 ft. you just need to conduct the swim test at 5000 ft.

8. Swim Facilities list:
This sheet will show places in the local area where swim testcan be conducted.

9. First Class Center Worksheet:
This form will help in scheduling your scouts to use the First Class Center, This form should be brought with you and turned in at check in on Sunday.

10. Merit Badge Pre-registration Chart:
Use this form in conjunction with the Merit Badge Schedule (See above) to help plan your Scouts’ week. Please note the AGE and RANK requirements for BSA Lifeguard, Lifesaving, Canoeing, Rowing, Astronomy, E Science, Climbing, Camping, Archery, Rifle and Shotgun. These AGE and RANK requirements WILL BE FOLLOWED AT CAMP. PLEASE DO NOT SET UP A SCOUT FOR DISAPPOINTMENT BY LETTING HIM SIGN UP FOR A CLASS HE WILL NOT BE ABLE TO PARTICIPATE IN.

11. Merit Badge Schedule:
All Merit Badge class sessions will be one and a quarter hours long, with 15 minutes down / travel time between each session. Use this schedule with the Program Planner to counsel and schedule your Scouts time at camp.

12. Program Planner Worksheet:
The Program Planner worksheet has a two-fold use.

• For your unit to use in merit badge pre-registration and
• To schedule your Scout’s week.