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Permission Slip

 (Typical) Trip Information and Permission Slip

PARENTS KEEP THIS PART

    Troop 993 is going to ......................................... on ................., 2004.  The trip leader is ..(410)..................  We will be departing from the Severna Park Methodist Church (SPUMC) at 8:00 am Saturday morning.  Saturday night we will be camping at ...........................................  The Scouts will be returning to SPUMC on Sunday at about .. pm.  The cost of the trip will be $...... (for each scout) which includes camping fees, "cracker barrel" and a share of the transportation costs.  Saturday lunch will be a "brown bag" from home.  Saturday evening and Sunday morning meals will be handled by patrol cooking with the cost shared among the patrol members.  Your Scout will need to bring some additional spending money for Sunday lunch at the "Golden Arches" (i.e. McDonalds).

    If you need to contact your Scout, and only in case of an emergency, call .. at (     )..............  It may be extremely difficult to make contact with the scouts. 

    NOTE:  Stealing, smoking, use of alcohol or illicit drugs, lying, swearing, cheating, fighting or other physical aggression, hazing and violation of health and safety rules are not tolerated.  Butane lighters, aerosol cans, fireworks, firearms and sheath knives are strictly forbidden.  Because our outdoor program is designed to provide an opportunity for our Scouts to experience nature, please leave radios, tape players, CD players and TV's at home.  If your scout is unwilling to comply with the troop rules, or is a danger to himself or others, he will be removed from the activity and you will be required to promptly retrieve your son (regardless of location or time).

Please detach and retain this section and return the rest of this form and a check payable to Troop 993 by Wednesday's Troop Meeting, ...........  If you are interested in driving or joining us on the trip, please contact............................

WAIVER OF RESPONSIBILITY

(TRIP LEADER COPY)

Activity: ................................................................................................................................................2004

To Troop 993 of the Boy Scouts of America sponsored by the Severna Park Methodist Church (SPUMC):

    In consideration of the benefits to be derived, and in view of the fact that the Boy Scouts of America is an educational institution, membership in which is voluntary, and having full confidence that every reasonable precaution will be taken to ensure the safety and well-being of my Scout son(s)/ward(s), namely:  ______________________________ on the activity named below, I agree to his participation and waive all claims against the leaders of this trip, officers, agents, and representatives of the Boy Scouts of America, and the sponsor.

    In the event of an emergency, the troop unit leader of the activity named below has my permission to obtain medical treatment for this Scout at the nearest hospital or doctor, at my expense, if our own doctor is not readily available, and as restricted on the emergency Data Sheet on file with Troop 993.  During the activity listed above, I can be contacted at the following phone(s) and will accept long distance collect calls.  (       )__________________; (       )__________________ .

Medical Insurance Information:  Company ____________________________________________________

Policy No. __________________________________(Control No. if group policy)_______________________

May the adult leader(s) administer "over-the-counter" medications to your son?  Yes____ No____

This Scout is highly allergic or sensitive to ________________________________________________________

What, if any, medication is this Scout taking? _____________________________________________________

Any special instructions for this medication? ______________________________________________________

Do you want the unit leader to carry the Scout's medication?  Yes _____ No_____ .

Date: ___________    __________________________________  ___________________________________

                                    Scout's Signature                                           Signature of Parent or Guardian