Cap Form 31 PDF Details

The Cap 31 form, officially known as the APPLICATION FOR CAP ENCAMPMENT OR SPECIAL ACTIVITY, serves a critical role in the Civil Air Patrol's operations, particularly in preparing members for participation in encampments or special activities. Detailing necessary information from personal data such as name, CAPID, and contact details to specific requirements like shirt size, height, and weight, it ensures that participants are adequately catered for during the activities. Additionally, the form encompasses sections dedicated to the applicant's medical history and emergency contact information to address any potential health concerns that may arise. Notably, it includes a RELEASE AGREEMENT and RELEASE BY PARENTS OR GUARDIAN sections, highlighting the voluntary nature of participation and the acknowledgment of risks involved, thereby absolving the Civil Air Patrol/United States of America of liability in case of any injury or property damage. This comprehensive approach underscores the CAP's commitment to safety, responsibility, and informed consent, making the Cap 31 form an indispensable part of the administrative process for encampments and special activities.

QuestionAnswer
Form NameCap Form 31
Form Length6 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 30 sec
Other namescap form application special, civil air patrol form 31, form cap 31, application encampment

Form Preview Example

APPLICATION FOR CAP ENCAMPMENT OR SPECIAL ACTIVITY

Name (Last, First, Middle Initial)

 

CAPID

CAP Grade

Gender

 

 

 

 

 

 

 

 

 

 

 

Member Type

 

Charter No. (e.g. GLR-MI-059)

Grade in School

Religious Preference

 

 

 

 

 

 

 

 

 

 

 

Address (Include No., Street, City, State and Zip Code)

Home Phone Number

 

Cell Phone Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

E-Mail Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date of Birth (mm/dd/yy)

Shirt Size

Height (Inches)

Weight (Lbs)

 

Hair Color

 

Eye Color

 

 

 

 

 

 

 

 

 

 

 

Title of Activity

 

 

Location of Activity

 

Activity Dates

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Staff Position(s) Sought

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Emergency Contact Information

 

 

 

 

 

 

 

 

 

(Primary Contact) Name (Last, First, Middle Initial)

Relationship

 

 

Primary Phone Number

 

 

 

 

 

(Secondary Contact) Name (Last, First, Middle Initial)

Relationship

 

 

Primary Phone Number

 

 

 

 

 

 

 

 

 

 

 

 

RELEASE AGREEMENT

KNOW ALL MEN BY THESE PRESENTS that I am submitting my application for Civil Air Patrol Special Activities or Encampments, and I hereby volunteer entirely upon my own initiative, risk, and responsibility for an assignment to participate in this activity of encampment at the first available opportunity and with full knowledge that such activity may include:

1.Traveling by land, sea, or air in US military, commercial, or privately owned vehicles from regular place or residence to the site of the activity or encampment, travel incident to the activity or encampment, and subsequent return to place of residence.

2.Participation in aeronautical activities as a passenger or student trainee in US military, commercial, or privately owned aircraft.

3.Living for a period of one week or more on diminished rations and minimal shelter simulating actual survival conditions.

4.Being quartered and/or subsisting away from regular or normal place of residence for an extended period of time.

5.Remaining with the cadet group I am assigned to at all times during the activity or encampment.

6.Acting as a spokesman for Civil Air Patrol, rendering reports on the activity or encampment.

7.Refraining from argumentative discussions concerning governmental policies.

In consideration of the permission extended to me by the Civil Air Patrol/United States of America through its officers and agents to participate in said activity/encampment or activities/encampments, I do hereby for myself, my heirs, executors, and administrators release and forever discharge the Civil Air Patrol, Inc./United States of America, and all its officers, agents, and employees acting official or otherwise, from any and all claims, demands, actions, or causes of action, on account of my death or on account of any injury to me or my property which may occur as a result of the negligence of the Civil Air Patrol/United States of America, its agents or employees during said activity/encampment or activities/encampments or continuances thereof, as well as all ground and flight operations incident thereto.

Date

 

Signature of Applicant

CAPF 60-81, Jun 19 (Previously CAPF 31) (Previous editions may be used)

OPR/ROUTING: CP

Name (Last, First, Middle Initial)

Title of Activity

RELEASE BY PARENTS OR GUARDIAN

KNOW ALL MEN BY THESE PRESENTS: WHEREBY my child has applied for the activity or encampment referred to above, In consideration of the permission extended to my child by the Civil Air Patrol/United States of America through its officers and agents to participate in said activity/encampment or activities/encampments, I do hereby for myself, my heirs, executors, and administrators release and forever discharge the Civil Air Patrol, Inc./United States of America, and all its officers, agents and employees acting official or otherwise, from any and all claims, demands, actions or causes of action, on account of the death or on account of any injury to my child which may occur as a result of the negligence of the Civil Air Patrol/United States of America, its agents or employees during said activity/encampment or activities/encampments or continuances thereof, as well as all ground and flight operations incident thereto. In addition, by my signature below, I certify the applicant:

1.Is my minor child or ward.

2.Has no history or injury or disease which might be affected by this activity except those previously noted in the Medical Information section of this form.

3.Will follow all rules, regulations, and directives as established by the Civil Air Patrol, Inc., activity project officer or encampment commander, or other staff members. If not following the above mentioned rules, regulations, and directives he/she may be sent home at the discretion of the project officer, encampment commander or activity directory at my expense.

However, in case of injury, disease or other illness, permission is hereby granted to treat the applicant as required, and if the applicant is released from the activity before recovery from said injury, disease, or illness, further treatment will be provided by myself.

Date

 

Witness for Father’s Signature

 

Father or Legal Guardian

 

 

 

 

 

 

 

Witness for Mother’s Signature

 

Mother or Legal Guardian

Squadron Certification. (Squadron Commander’s signature is not necessary if the activity is approved in eServices or if it is a squadron activity.)

I certify that the above information is correct and that all requirements for attendance, as specified in National Headquarters Directives, will be completed by the required dates.

Date

 

Squadron Commander

Group Certification. (Group Commander’s signature is not necessary if the activity is approved in eServices or if the activity is held within the group.)

Date

 

Group Commander (or designee)

Wing Certification. (Wing Commander’s signature is not necessary if the activity is approved in eServices or if the activity is held within the wing.)

 

Date

 

Wing Commander (or designee)

 

CAPF 60-81 Reverse

 

OPR/ROUTING: CP

CAP MEMBER HEALTH HISTORY FORM

This information is CONFIDENTIAL and for official use only. It cannot be released to unauthorized persons. Answer all questions as accurately as possible so that the activity or encampment staff can make themselves aware of any pre-existing medical problems or conditions and be alert to help you. This form will also provide medical information in a case when you are unable to do so.

Name (Last, First, Middle)

 

 

Grade

CAPID

Charter Number

 

 

 

 

 

 

Date of Birth

Height

Weight

Hair Color

Eye Color

Gender

 

 

 

 

 

 

Allergies: List Names of Medication or Other Allergies (i.e., bee sting, food, plants) and types of reactions; please note food allergy details with dietary restrictions below on back as well.

Do You Now Have Or Have You Ever Had Any Of The Following? Explain any yes’ in the remarks section below or attach additional sheet. Conditions not specifically noted below having the potential to interfere with performance during the special activity or encampment should be documented in the remarks section.)

If “Yes” is marked in an item with multiple choices, please circle which problem applies.

No Yes

No Yes

Decreased vision, glaucoma, contacts

Chronic or recurring injuries

Ear infections, perforation

Activity, mobility restrictions

Difficulty equalizing ears

Use of cane, walker, wheelchair

Hearing loss, hearing aid

Back or neck pain or injury

Allergies, nasal stuffiness

Migraine or severe headaches

Anaphylaxis, serious allergic reaction

Dizziness or fainting spells

Asthma, emphysema (COPD)

Head injury, unconsciousness

Ever use an inhaler

Epilepsy or seizure

Short of Breath with activity

Stroke, paralysis

Heart Attack, chest pain, angina

Thyroid problems (low or high)

Heart murmur, heart problems

Diabetes, high or low blood sugars

Congestive heart failure

Cancer, leukemia

Irregular or rapid heartbeat

Blood disease, hemophilia

High or low blood pressure

Motion sickness

Stomach trouble, ulcers

Special diet, food allergies

Hepatitis or liver problems

Current bedwetting problems

Diarrhea, constipation

ADD (Attention Deficit Disorder)

Hernia or rupture

Mental illness (bipolar, other)

Kidney disease or stones

Depression, anxiety, suicidal

Prostate problems (men)

Admission to the hospital

Frequent urination

Other chronic medical illnesses

Menstrual cramps (women)

Sleep disorder, sleep apnea

Broken bone, joint problems

Serious Injury

CAPF 160 JUN 13

OPR/ROUTING: HS

EMERGENCY INFORMATION

(Insurance/Physician Information, Emergency Contacts, Minor Consents

Name (Last, First, Middle)

Grade

CAPID

Charter Number

 

 

 

 

 

Mailing Address (Number and Street)

City

 

State

Zip Code

 

 

 

 

 

(Area Code) Home Phone

(Area Code) Cell Phone

Primary Insurance Information (Please attach copy of insurance cards, front and back)

Medical Insurance Company

Policy Number

Group Code/Number

Co-Pay Amount

 

 

 

$

 

 

 

 

Prescription Coverage Company

Policy Number

Group Code/Number

Co-Pay Amount

 

 

 

$

 

 

 

 

Family Physician

Name

(Area Code) Phone

Mailing Address (Number and Street)

City

State

Zip Code

Emergency Contact (Parent, guardian or closest relative to be notified in case of emergency)

Name

 

 

Relationship to Applicant

 

 

 

 

 

 

Mailing Address (Number and Street)

City

State

Zip Code

 

 

 

 

 

(Area Code) Pager

(Area Code) Cell/Mobile Phone

(Area Code) Day Phone

(Area Code) Night Phone

 

 

 

 

 

Unit Commander Name and Grade

Unit Name

 

 

 

 

(Area Code) Unit Commander Day Phone

(Area Code) Unit Commander Night Phone

 

 

 

 

 

 

CAPF 161, JUN 13

OPR/ROUTING: HS

Dietary Restrictions or Limitations (List any dietary restrictions like food allergies, diabetes, gluten-free, vegetarian diets, etc.)

Past Surgical History (List all surgeries including tonsils, ear tubes, appendix, gall bladder, hernia, hysterectomy, heart, heart catheterization, bone and joint and all other surgeries.)

Date Tetanus

Booster

No Td or Tdap

Date:

Hepatitis Vaccine

No

Date:

Pneumonia

Vaccine

No

Date:

Varicella Immuni- zation/chickenpox No

Date:

Influenza Vaccine

No

Date:

Medication Information - Include supplements, over-the-counter medicines, herbals, creams, etc., or write “None”.

 

 

Times

 

Any Special Dosing or Storage

Name of Medication/Inhaler

Tablet

taken

Reason for

Instructions (i.e., as needed, with

Strength

per day

Medication

meals, must be refrigerated, etc.)

1.

 

 

 

 

 

 

 

 

 

2.

 

 

 

 

 

 

 

 

 

3.

 

 

 

 

 

 

 

 

 

4.

 

 

 

 

 

 

 

 

 

Social History

Tobacco Use (packs per day, years smoked, smokeless tobacco use)

Occupation (student or other)

Religious Preference

Remarks (Attach additional sheet if needed)

CONSENT FOR MINOR CADET PARTICIPATION, MEDICATIONS, TREATMENT

I give permission for full participation in CAP programs, subject to any limitations noted herein.

My signature below evidences my consent for my child/ward to possess and self-administer the prescription medications listed above I understand that there are legal limitations imposed on CAP senior members with regard to the involuntary administration of medications to my child/ward. (Cross out if permission is denied).

In case of emergency, I understand every effort will be made to contact me. In the event I cannot be reached, I hereby give my permission to the licensed health-care practitioner selected by the adult leader in charge to secure proper treatment, including hospitalization, anesthesia, surgery, or injections of medication for my child. Medical providers are authorized to disclose to the adult in charge exam/test results and treatment provided.

___________________________

________________________________________________________________________________________________________

DATE

SIGNATURE OF PARENT/GUARDIAN

CAP Form 160 Reverse

PERMISSION FOR PROVISION OF MINOR CADET OVER-THE-COUNTER MEDICATION

This form may not be usable in some states due to statutes concerning who can administer medications and administration conditions. Wings with such restrictions will publish appropriate additional guidance in a supplement to CAPR 160-1.

Name (Last, First, Middle)

Grade

CAPID

Charter Number

Over-The Counter/Non-Prescription Medications

The following over-the counter medications may be administered according to package directions by CAP senior members. Cross out any medications not approved.

Acetaminophen (Tylenol) for fever or pain Ibuprofen (Advil, Motrin) for fever or pain

Bacitracin or Neosporin antibiotic ointment to prevent infection

Hydrocortisone anti-inflammatory rash cream Calamine/Caladryl for poison ivy itch relief

Antifungal creams and sprays for treatment of fungal rashes

Visine eye drops for dry, irritated eye relief Op-Con A eye drops for allergic conjunctivitis

Benadryl liquid/tabs for allergic reactions

Claritin antihistamine for seasonal allergies

Robitussin products for relief of cough and cold symptoms

Delsym to suppress cough

Tums or Maalox for relief of stomach upset

Allergies

My child/ward has the following allergies or reactions to over-the-counter medications (list type of reaction):

Consent For Minor Cadet To Receive Over-The-Counter Medications My signature below evidences my consent for CAP senior members to provide over-the- counter non-prescription medications (such as those listed above) to my child/ward if indicated in the reasonable judgment of such senior members. I understand that I will be informed if any such medications are administered.

Date

Signature of Parent/Guardian

CAPF 163, JUN 13

OPR/ROUTING: HS

How to Edit Cap Form 31 Online for Free

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Step 1: This page includes an orange button that says "Get Form Now". Click it.

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In order to fill out the file, provide the information the software will require you to for each of the following segments:

step 1 to filling in cap form 31

In the In consideration of the permission, Date, Signature of Applicant, CAPF Jun Previously CAPF, and OPRROUTING CP field, put in writing your details.

stage 2 to completing cap form 31

Within the section referring to Name Last First Middle Initial, Title of Activity, RELEASE BY PARENTS OR GUARDIAN, Is my minor child or ward, Has no history or injury or, Will follow all rules regulations, However in case of injury disease, Date, Witness for Fathers Signature, and Father or Legal Guardian, you should put down some expected information.

cap form 31 Name Last First Middle Initial, Title of Activity, RELEASE BY PARENTS OR GUARDIAN, Is my minor child or ward, Has no history or injury or, Will follow all rules regulations, However in case of injury disease, Date, Witness for Fathers Signature, and Father or Legal Guardian fields to complete

The Squadron Certification Squadron, Date Group Certification Group, Squadron Commander, Date Wing Certification Wing, Group Commander or designee, Date CAPF Reverse, Wing Commander or designee, and OPRROUTING CP section is the place to place the rights and obligations of each party.

step 4 to entering details in cap form 31

Finalize by analyzing the next areas and completing them accordingly: This information is CONFIDENTIAL, Name Last First Middle, Grade, CAPID, Charter Number, Date of Birth, Height, Weight, Hair Color, Eye Color, Gender, Allergies List Names of Medication, Do You Now Have Or Have You Ever, If Yes is marked in an item with, and No Yes.

Filling out cap form 31 stage 5

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