PERMISSION SLIP - TROOP 30 OUTING
Firebird District Camporee at Estrella Mountain Park on April 19,20,21 2002
MUST BE TURNED IN BY END OF TROOP MEETING Monday April-8
The outing leaders in charge will be: Dr. Bob Bohanske & Rick Erman
We expect to leave from Larkspur at 5pm on the Friday
(NOTE: departure times are firm please be sure your Scout has had dinner)
We expect to return to Larkspur at 1pm on Sunday
(NOTE: return times depend on weather, traffic, distance and break camp speed)
Cost for the event is: $9 per person. ($8 Camporee admission and $1 Park Entrance fee) Food costs will be additional and split by Scouts in each patrol. (Your Patrol Leader will arrange Patrol food purchase and expenses)
Emergency Leader cell phone/pager: Bob Bohanske (602) 681-5111
-+-+-+-+-+-+-+-+-+-+-+-+-+--+-+-+-+-+-+-+-+ Clip and Return the Bottom half! +-+-+-+-+-+-+-+-+-+-+-+-+-+-+-+-+-+-+-+-+-+-+-
ADULTS NAME:______________________________
SCOUTS NAME:______________________________ PATROL:_______________________ has permission to attend the Troop 30 Outing on: Friday 4/19 going to Firebird District Camporee.
He will be responsible for his own personal equipment. I will make sure he does not attend if he is not feeling well.
In case of accident or illness, the Leaders of Troop 30, Grand Canyon Council, or the Boy Scouts of America have my permission to secure medical attention, as they deem necessary.
This authorization applies whether the charges are covered by the Scout insurance or by myself.
Date_________________ Signature X_________________________________________
Medical Insurance Company name: _____________________________________ Policy #__________________
The phone at which you may be reached during the Troop outing ( )________-______________
Secondary contact: Name________________________________ Ph. ( )________-______________
Prior to any scouts first outing with Troop 30, and annually prior to summer camp each year, a notarized Consent to Treat Form and a Personal Health and Medical Record Class 1 and Class 2 must be filed with the Troop. Please note any changes in medications or health status of your Scout since the last Medical was filed with the Troop.
List any medication your son will be taking on this Outing: (must be turned in to the Outing Leader)
________________________ and ________________________ and ___________________________
_____ I am planning on driving & have seats w/seatbelts for _____ Scouts in addition to my own Scout.
I drive a _______________ (color) _______________ (make) __________________ (model)
I will have a cell phone with me on the trip ( ) ________- _______________
______ I will not be available to drive on this outing.
______ I have a CB radio for my vehicle. (Troop 30 uses CB channel 30)
- - - - - - - - - - - - - - - - - - - - - Below to be completed by Trip Coordinators - - - - - - - - - - - - - - - - - - - - -
Date submitted _________________, Time __________ Sequence number ____________
Paid by: Check number__________, Cash Amount _________, "Camp Account" Amount __________