For the Troop Four Camping Trip on January 3/4 at the Hopedale Parklands in Hopedale MA

_____________________________________ has my permission to attend the event as noted above. If I can not be reached in a medical emergency, I authorize the Adult Leaders to obtain the appropriate medical care, at my expense, if necessary.

During the event I can be reached at the following telephone # ______________

If I can not be reached, please contact __________________________

at this telephone #______________________ Relationship to scout __________

Signed _____________________________________ Date ____________
I would like to (please circle)

• drive to the event and take ____ scouts

• drive from the event and take ____ scouts

• drive & attend and take ____ scouts

Arrival Time on Saturday: 10AM (parish center)
Pickup Time on Sunday 11AM (parish center)

Permission Slip is due at the Dec 18 troop meeting. Campout planning is based on forms received at the beginning of this troop meeting. Call Phil Bedard at 508-282-0283 if your scout would like to attend the camping trip, but can not attend the Dec 18th troop meeting.

For Adults Driving (needed for BSA tour permit):

Vehicle Make: _______________

Vehicle Model: _______________

Vehicle Year: ________________

Drivers License #______________

There is no fee required for this camping trip.