2011-12 BSA Health & Medical Form ABC

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" height=90 BGCOLOR="#006699" TEXT="#080000" bgproperties="fixed" background="02c285a1erlcgo.png"> <div> <FONT SIZE="4" COLOR="#FFCC66" FACE="Arial" ><B>BSA - Pack 901 Clinton Township, NJ</B></FONT><B>     |     </B><A HREF="index.htm" TARGET="_top" TITLE="BSA Pack 901 Clinton Township, NJ"><U><B>home</B></U></A></div> <div> <IMG BORDER="0" SRC="1x1.gif" HEIGHT="14" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" WIDTH="14">   <IMG BORDER="0" SRC="1x1.gif" HEIGHT="14" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" WIDTH="14">     <IMG BORDER="0" SRC="1x1.gif" HEIGHT="14" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" WIDTH="14">  <IMG BORDER="0" SRC="1x1.gif" HEIGHT="14" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" WIDTH="14"><FONT SIZE="2" COLOR="#CCCCCC" FACE="Arial" ><B> </B></FONT><FONT SIZE="4" COLOR="#FFFF33" FACE="Arial" ><B> </B></FONT><FONT SIZE="1" COLOR="#BBBBBB" FACE="Arial" ><B>2011-12 BSA Health & Medical Form ABC</B></FONT></div> <div> <B><U>Fill out Only Sections A & B --- You do NOT need to fill out Section C</U></B></div> </td> </tr><tr> <td valign="top" height=390 BGCOLOR="#C0C0C0" TEXT="#080000"> <bR> </td> </tr></table></body>