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BSA TROOP 96 PERMISSION SLIP – August Caving Campout

SIGNED PERMISSION SLIPS DUE:  Monday, 8/16/2021

EVENT DATES:  Friday, 8/20  to Sunday, 8/22

EVENT LOCATION: Camping at Mississippi Palisades and caving at Maquoketa State Park

Meeting time: Gather 5 pm Friday at St. Gilbert Church Parking Lot

RETURN: Pickup Sunday at 11 am at St. Gilbert Church Parking Lot  

UNIFORM / CLOTHING: CLASS A UNIFORM for traveling

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BSA TROOP 96 PERMISSION SLIP – August Caving Campout

SIGNED PERMISSION SLIPS DUE:  Monday, 8/16/2021

EVENT DATES:  Friday, 8/20  to Sunday, 8/22

EVENT LOCATION: Camping at Mississippi Palisades and caving at Maquoketa State Park

Meeting time: Gather 5 pm Friday at St. Gilbert Church Parking Lot

RETURN: Pickup Sunday at 11 am at St. Gilbert Church Parking Lot  

UNIFORM / CLOTHING: CLASS A UNIFORM for traveling

SCOUT(S)___________________________and_______________________________hasmy permission for full participation in BSA programs, subject to the limitations noted herein. I further agree that Troop 96 and its Junior and Adult Leaders, as well as the St. Gilbert Church and the Knights of Columbus shall be held free from liability, financially or otherwise, for any injury or accident incurred by my son during this event. I understand that covid-19 safety protocol adherence is the responsibility of the participant (youth and adult) while participating in the Troop 96 campout. I have also included a separate sheet with any special instructions regarding my son.

In case of emergency, I understand every effort will be made to contact me (or someone else if noted on this form). In the event I cannot be reached, I hereby give my permission to the medical personnel selected by the adult leader in charge to secure proper treatment, including hospitalization, anesthesia, surgery, or injections of medication for my child.  

Parent (Guardian) Signature: ____________________________Dated:____/____/____  

Parent phone #_________________________ Text # __________________________Carrier: _________

   

Allergies or other important information in an emergency: _________________________________

Medications: _________________________________________________________________________________

_____________________________________________________________________________________________

SPECIAL NOTE TO PARENTS:  ONLY PARENTS OR OTHER FAMILY MEMBERS CAN PICK UP YOUR SCOUT.  IF ANYONE ELSE IS TO BRING YOUR SON HOME YOU MUST PROVIDE THAT AUTHORIZATION BELOW:

(NAME)__________________________(CELL)____________________ IS AUTHORIZED TO PICK UP MY SCOUT
AT THE CHURCH  (PARENT SIGNATURE) ____________________________________DATE____/____/______