Permission Request Form (January 2022)
Please complete this permission request form for the Klondike Derby on January 15, 2022 at Quail Hill Scout Reservation. After completing the form you will receive an email with a PDF with the permission slip for you to sign and return.
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Participant Last Name *
Participant First Name *
Participant Cell Phone #
This is the mobile # of the participant, not the mother or father or brother or grandmother, etc.  If no mobile #, leave blank.
Patrol Name *
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