PERMISSION SLIP             Paid _____

 

  TROOP 97 CAMPOUT           Debit _____

 

 

BILL WALTMAN   H 671-1558                             Therese Kneipp 925-8888

SCOUTMASTER    C 286-9324                             COMMITTEE CHAIRWOMAN

 

ASSISTANT SCOUTMASTERS

 

JERRY CARLISLE  686-7926                              KEN LOECHNER    631-3722

ERNIE SMITH     687-9426                              PAUL KNEIPP     925-8888
MIKE HAY        423-1295                              JIM STEPHENSON  381-3637

TIM KAYLOR      683-3831                              JAMES TILLMAN   925-9889

MARK DRABEK     925-3354                             

 

As the parent or legal guardian of __________________________________, I hereby

give my permission for him to participate in an outing with Troop 97.

 

Date:   2/17th  2/19th                                

                                     

Location: Kisatchie (Red Dirt Area)  

                                                              

Permission Slips Due: 2-13-12

 

Please, No Late Request.

             

COST: $20.00   

 

Time/Place of Departure: 6:00 PM Friday Feb 17th from Summer Grove United

                         Methodist Church

 

Time/Place of Return:    1:00PM 2:00PM Sunday Feb 19th - YOUR SON WILL CALL YOU

 

I give permission to the leaders of the above unit to render First Aid,

should the need arise.  In the event of an emergency, I also give

permission to the physician, selected by the adult leader in charge, too

hospitalize, secure proper anesthesia, order injection, or secure other

medical treatment, as needed.  I further agree to hold the above named

unit and its leaders blameless for any accidents that might occur during

this outing except for clear acts of negligence or non-adherence to BSA

policies and guidelines.

 

In case of emergency, I can be reached by phone at ________________

 

or ________________.  If I cannot be reached, please contact

 

____________________________________ at ____________________________.

 

Signed:  _________________________________________   Date: ___________

(Parent or Guardian)

Please Detach and Keep

Emergency Contact Numbers:

Bill Waltman         Cell 286-9324                     Paul Kneipp          Cell  564-8043

Lindy)               Home 671-1558                     Ernie Smith          Cell  423-9426

Jim Stephenson       Cell 381-3637