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Boy Scouts of America Troop 716

Parental Permission Form

Name: ______________________________________________ X-Scout: ________ X-Leader: _______ Address: __________________________________City: _____________ St: ____________ Zip: ______ Patrol Name:__________________________________
Has my permission to attend the above event. I will not hold Peace Presbyterian Church, Troop 716 or the leaders liable for any accidents that might occur except for clear acts of negligence or non-adherence to BSA policies and guidelines. In the event of an emergency, I give my permission to the physician, selected by the leaders in charge, to hospitalize, secure proper anesthesia, order injections or secure other medical treatment as needed.

**All fees are non-refundable but are transferable to another Scout. **All Scouts and leaders must have a current medical form completed in order to attend.

Health conditions that the group leader should be aware of: ____________________________________________________________________________________ Medications to be taken:_________________________________________________________ ANY SPECIAL INSTRUCTIONS FOR THIS MEDICATION? ____________________________________________________________________________________ Note: Individual Scouts and Scouters are responsible for safe keeping and proper self dosage of all medications Parent/legal guardian signature: ________________________________ Address: _____________________________________________________ City: ______________________ St: ______________ Zip: ______ Home phone:__________________ Work phone: _______________ Cell phone: ______________ Special Notes: Total Cost per Scout / Leader BE at Peace at 5:30pm. We will leave the church Friday 6:00 pm Returning Sunday appox.12 noon Use the check lists in the Boy Scout handbook to make sure you have all the necessary gear. Uniform will Class A for travel.

CELL PHONES ARE NOT ALLOW ON CAMP OUTS. FEED Your Scout before leaving home! Have your Scout bring 1 canteens of water . Bring Camp chair
Bring your completed permission slip with you Friday night with fee. ******Please advise if you will be driving to the event.

This will help our planning.