BSA TROOP 96 PERMISSION SLIP – Shooting Sports Campout

SIGNED PERMISSION SLIPS DUE:  Monday, April 8, 2019

EVENT DATES:  Friday, April 12 to Sunday, April 14, 2019

EVENT LOCATION: Campout @ Van Patton Woods and Bristol Gun Range

Meeting time: Gather at 5:15 pm Friday – St. Gilbert Parking Lot

RETURN: approx 11:00 AM, Sunday

EVENT COST:  $15/per scout for food cash.  

UNIFORM / CLOTHING: CLASS A UNIFORM for traveling

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BSA TROOP 96 PERMISSION SLIP – Shooting Sports Campout

EVENT DATES:   Friday, April 12 to Sunday, April 14, 2019

EVENT LOCATION: Campout @ Van Patton Woods and Bristol Gun Range

DEPART: 5:15 pm Friday – StG parking lot

SCOUT(S)___________________________and_______________________________has

my 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 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: _________

Adult Attending? Y / N   Who: __________ Arriving day/time: ________  Departing day/time: ________

Can Drive?: Y / N      To Camp? Y / N      From Camp? Y / N      # of passengers including son(s) _____

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____/____/______