PERMISSION SLIP             Paid _____


  TROOP 97 CAMPOUT           Debit _____



BILL WALTMAN   H 671-1558                             Therese Kneipp 925-8888

SCOUTMASTER    C 286-9324                             COMMITTEE CHAIRWOMAN




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