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
JASON HARBUCK   868-9203                              MIKE HAY        423-1295

KEVIN HUNTER    426-0790                              HARRY WATSON    564-6914

MARK DRABEK     925-3354                              TIM KAYLOR      346-9668
PAUL NORTON     422-6150                              JIM STEVENSON   381-3637
 

As the parent or legal guardian of __________________________________, I hereby

give my permission for him to participate in an outing with Troop 97.

 

Date:  May 16th – 17th                           

                                     

Location:  Cypress Lake                           

                                                              

Permission Slips Due: 05/05/2008

             

COST: $20.00 for scout.  $5.00 for each additional family member. Siblings under 5 years of age are no charge.

  

$5.00 LATE FEE AFTER May 5th

  

Time/Place of Departure: 6:00 PM Friday May 16th from Summer Grove United Methodist Church

 

Time/Place of Return:    1:00 – 2:00PM   Sunday - 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