Permission Slip – Camping Trip – January 2011

Troop Four Permission Slip

For the Troop Four Winter Camping Trip on January 22-23 at Blackstone Canal and Heritage State Park in Uxbridge MA

_____________________________________ 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 ____________
Parents, please check as applicable

____ I plan to attend the event & can drive ____ scouts*

____ I won’t be attending, but can drive ___ scouts* to the event

____ I won’t be attending, but can drive ___ scouts* back from the event
* include your own scout in the count

Permission Slip is due at the Jan 13th Troop Meeting. Call or email Phil Bedard at 508-478-5773,,  if your scout would like to attend the camping trip, but can not attend the Jan 13th troop meeting.

There is no fee for this camping trip.