Permission Slip – Backpacking – October 2009

For the Troop Four Camping Trip on October 23-25 to the Taconic Mountains in the MA/CT/NY Tri State Area

_____________________________________ has my permission to attend the event as noted above and below. 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 prefer to ____ Drive, participate in the event & take ____ scouts* (Sat – Sun option)

____ Drive, participate in the event & take ____ scouts* (Fri – Sun option)

____ I will not be driving, but my son is attending the Sat-Sun option

____ I will not be driving, but my son is attending the Fri-Sun option
Registered Adult Leaders Only – check off if applicable: ____ I am flexible, and can drive/attend either option to help balance the leadership, but the earlier check mark indicates my preference.

* include your own scout in the count

Permission Slip is due at the Oct 1st troop meeting. Call Phil Bedard at 508-282-0283 if your scout would like to attend the camping trip, but can not attend the Oct 1st troop meeting.

For Adults Driving (needed for BSA tour permit):

Vehicle Make: _______________

Vehicle Model: _______________

Vehicle Year: ________________

Drivers License #______________

To offset the cost of the AMC Cabin, a nominal $5 fee is required for each scout. Checks are preferable form of payment, made payable to Troop 4.