PERMISSION SLIP Paid _____
TROOP 97 CAMPOUT Debit _____
BILL WALTMAN H 671-1558 Therese Kneipp 925-8888
SCOUTMASTER C 286-9324 COMMITTEE CHAIRWOMAN
ASSISTANT SCOUTMASTERS
JERRY CARLISLE 686-7926 KEN LOECHNER 631-3722
ERNIE SMITH 687-9426
PAUL KNEIPP 925-8888
MIKE HAY 423-1295 JIM STEPHENSON
381-3637
TIM KAYLOR 683-3831 JAMES TILLMAN 925-9889
MARK DRABEK 925-3354
As the parent or legal guardian of __________________________________, I hereby
give my permission for him to participate in an outing with Troop 97.
Date: 2/17th – 2/19th
Location: Kisatchie (Red Dirt Area)
Permission Slips Due: 2-13-12
Please, No Late Request.
COST: $20.00
Time/Place of Departure: 6:00 PM Friday Feb 17th from Summer Grove United
Methodist Church
Time/Place of Return: 1:00PM – 2:00PM Sunday Feb 19th - YOUR SON WILL CALL YOU
I give permission to the leaders of the above unit to render First Aid,
should the need arise. In the event of an emergency, I also give
permission to the physician, selected by the adult leader in charge, too
hospitalize, secure proper anesthesia, order injection, or secure other
medical treatment, as needed. I further agree to hold the above named
unit and its leaders blameless for any accidents that might occur during
this outing except for clear acts of negligence or non-adherence to BSA
policies and guidelines.
In case of emergency, I can be reached by phone at ________________
or ________________. If I cannot be reached, please contact
____________________________________ at ____________________________.
Signed: _________________________________________ Date: ___________
(Parent or Guardian)
Please Detach and Keep
Emergency Contact Numbers:
Bill Waltman Cell 286-9324 Paul Kneipp Cell 564-8043
Lindy) Home 671-1558 Ernie Smith Cell 423-9426
Jim Stephenson Cell 381-3637