For the January Camping Trip on January 12 – 13 at Blackstone Canal in Upton, 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 1:

____ I would like to camp, too, and can drive ____ scouts both ways

____ 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 January 3rd troop meeting. Call Ron Gorham at 508-868-8793 or email at gorhamfamily6@verizon.net if your scout would like to attend the camping trip, but can’t attend the January 3rd meeting to sign up.