Air Force Form 1181 – Fill Out and Use This PDF

The Air Force 1181 form is an essential document used within the Air Force Youth Flight Program for patron registration, including capturing crucial information such as authorization for medical treatment in emergency situations, field trips authorization, and details about the child and sponsor like immunization records, known allergies, and special needs. It serves a significant role in ensuring the safety and preparedness of children participating in the program by facilitating emergency medical care and fulfilling other lawful purposes like law enforcement and litigation. Ensuring the form is correctly filled out enhances the readiness and well-being of young participants in the Air Force community. If you're ready to complete the form for your child, click the button below.

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Air Force Form 1181 PDF Details

The Air Force 1181 form serves a critical purpose within the framework of the Youth Flight Programs, designed to ensure the safety and well-being of the children participating. Structured under the auspices of the Privacy Act, its authority is drawn from key legislative and executive directives, including 10 USC 8013 and EO 9397, guaranteeing that personal data is managed with the utmost care. Its principal aims are manifold, extending beyond emergency medical treatments to encompass permission for field trips, the cataloging of personal and health-related details, and even financial information for fee adjustments. This form not only facilitates medical care in urgent situations but also streamlines the process of identification and the maintenance of essential records. In the event of an emergency, it permits the sharing of information with civilian medical providers, thereby ensuring swift and informed intervention. Furthermore, the details captured by the form might be disclosed to various governmental entities, reflecting its broader utility in serving lawful purposes, including law enforcement and litigation. Although submitting this information is voluntary, the absence of these details could preclude children from participation in the programs. As such, it embodies a comprehensive approach to child safety, touching on every facet from immunizations and allergies to special needs care, thereby reinforcing the Air Force’s commitment to the responsible and considerate handling of sensitive information.

Question	Answer
Form Name	Air Force Form 1181
Form Length	1 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	15 sec
Other names	1181 form, 1181 permanent maintained pdf, us air force application form, 1181 permanent record

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AIR FORCE YOUTH FLIGHT PROGRAM PATRON REGISTRATION

PRIVACY ACT STATEMENT

AUTHORITY: 10 USC 8013; 44 USC 3101; EO 9397

PRINCIPAL PURPOSES: To provide Youth Flight Programs with authorization for medical treatment in emergency situations; authorization for field trips; identify children and sponsor, record required immunizations; record known allergies; record income data; record special needs requirements; and record special instructions.

ROUTINE USES: Form may be furnished to civilian doctors or hospitals in course of obtaining emergency medical attention for children. Information furnished may be disclosed, upon request, to other Federal, state or local governmental agencies in the pursuit of their official duties. Finally, it may be used for other lawful purposes including law enforcement and litigation.

DISCLOSURE IS VOLUNTARY: Failure to furnish information, including SSN, will result in denial of admission of child(ren) to Youth Flight Programs. SSN is used for positive identification of individuals and records.

CHILD'S NAME

HOME PHONE

ADDRESS

MARITAL STATUS

SPONSOR (Last, First, Middle Initial)	SPOUSE (Last, First, Middle Initial)

RANK/GRADE	RANK/GRADE

DUTY PHONE	DUTY PHONE

ORGANIZATION	EMERGENCY CONTACT

SPONSOR'S SSN	SPOUSE'S SSN

FEES

DEROS/ID EXPIRES

BRANCH OF SERVICE

EMERGENCY PHONE

HOSPITAL PHONE

PHYSICIAN'S NAME

VACCINE /

4-6

11-12

14-16

SEX

MALE

DATE OF BIRTH (Day, Month, Year)

BIRTH

DATE RECEIVED

MOS

YRS

(X One)

FEMALE

Hepatitis B

I authorize emergency treatment for the children

named hereon:

1st

Hep B-1

2nd

3rd

Hep B-2

Hep B-3

Hep B

4th

Diphtheria-Tetanus,

SIGNATURE

DATE

Pertussis

1st

(YYYYMMDD)

2nd

DTP

3rd

DTP

DTP DTIP

DTP

SPECIAL INSTRUCTIONS

4th

DTAP

5th

6th

H.Influenzane type b

1st

2nd

3rd

Hib

4th

Polio

SPECIAL NEEDS CARE /CHRONIC ILLNESSES /ALLERGIES

1st

2nd

OPV OPV

OPV

3rd

OPV

4th

Measles, Mumps,

Rubella

1st

MMR

MMR OR MMR

2nd

Varicella

Zoster

Virus Vaccine

1st

VZV

2nd

OTHER IMMUNIZATIONS AS REQUIRED:

NAMES OF ADDITIONAL CHILDREN

ADULTS AUTHORIZED TO SIGN CHILDREN IN / OUT

ENROLLED IN PROGRAM:

VACCINE TYPE:

DATE:

VACCINE TYPE:

DATE:

VACCINE TYPE:

DATE:

VACCINE TYPE:

DATE:

AUTHORIZATION FOR FIELD TRIPS

FAMILY INCOME (Adjusted

gross--most

recent 1040):

PROVIDE ONLY IF REDUCED FEES ARE REQUESTED.

SINGLE / DUAL INCOME

(Circle One)

IT IS THE RESPONSIBILITY OF EACH SPONSOR TO

ENSURE IMMUNIZATIONS AND EMERGENCY

PARENT SIGNATURE

INFORMATION IS UP TO DATE. FAILURE TO

UPDATE MAY RESULT IN REFUSAL OF SERVICE.

AF FORM 1181, 19960501 (EF-V3)

PREVIOUS EDITION IS OBSOLETE.

How to Edit Air Force Form 1181 Online for Free

Handling PDF documents online is super easy using our PDF editor. Anyone can fill in youth flight registration here in a matter of minutes. Our professional team is constantly endeavoring to develop the editor and enable it to be much faster for users with its extensive features. Enjoy an ever-evolving experience today! Starting is easy! All you should do is take the next easy steps directly below:

Step 1: Open the PDF doc in our tool by clicking the "Get Form Button" in the top section of this webpage.

Step 2: As soon as you open the PDF editor, you will find the document prepared to be filled out. Other than filling out various blanks, you might also do many other actions with the Document, namely putting on custom textual content, changing the original text, inserting illustrations or photos, signing the PDF, and more.

This form will need particular data to be typed in, thus be sure you take your time to enter what's expected:

1. The youth flight registration requires particular details to be entered. Be sure that the next blanks are completed:

1181 permanent maintained pdf conclusion process clarified (part 1)

2. Once your current task is complete, take the next step – fill out all of these fields - Polio, th Measles Mumps Rubella st, nd Varicella Zoster Virus Vaccine, SPECIAL NEEDS CARE CHRONIC, OPV, OPV, OPV, OPV, MMR, MMR OR MMR, VZV, VZV, OTHER IMMUNIZATIONS AS REQUIRED, NAMES OF ADDITIONAL CHILDREN, and ADULTS AUTHORIZED TO SIGN CHILDREN with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

VZV, OTHER IMMUNIZATIONS AS REQUIRED, and OPV of 1181 permanent maintained pdf

Always be very mindful while completing VZV and OTHER IMMUNIZATIONS AS REQUIRED, since this is where a lot of people make some mistakes.

Step 3: Before obtaining the next step, check that form fields were filled in the proper way. The moment you’re satisfied with it, click “Done." Go for a 7-day free trial account at FormsPal and obtain immediate access to youth flight registration - which you may then use as you want in your personal account. Here at FormsPal.com, we do our utmost to make sure your information is maintained private.

Air Force Form 1181 – Fill Out and Use This PDF

Air Force Form 1181 PDF Details

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