For the Troop Four Camping Trip on January 21-22 at Upton’s Peppercorn Forest

_____________________________________ 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.  There is no cost for this trip.

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 one:   

 ____ I am available to drive & participate & can take ____ scouts

____ I’m not available to participate, but can drive there & take ___ scouts

____ I’m not available to participate, but can drive back & take ___ scouts

Permission Slip is due at the Jan 12 troop meeting.    Call Phil Bedard at 508-561-7058 if your scout would like to attend the camping trip, but can’t attend the Jan 12 meeting to sign up.

For Adults Driving (needed for BSA tour permit):

Vehicle Make: _______________

Vehicle Model: _______________

Vehicle Year: ________________

Drivers License #______________ (drivers license number, not license plate number)