Parent Permission Slip

 

Boy Scout Troop 196

 

 

I __________________________________________ give my permission to

                                    (Name of Parent)

allow ______________________________________ to attend an

                                    (Name of Scout)

overnight campout activity at ___________________________________

                                                                        (location of campout)

with Boy Scout Troop 196 on _________________________________. 

                                                            (date of campout)

I understand that there will be a minimum of two adult leaders at all times during the activity.  I will
arrange for my son to be picked up after the activity and ensure that he has the proper clothes, equipment
and money necessary for this activity.  I certify that my son does not require any medication, special
food or special needs unless specifically described below. (Please write N/A if none) 

 

Medication or special food needs:

________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

 

Allergic reactions: (Please write N/A if none)

________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

 

Special Needs: (Please write N/A if none)

________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

 

In Case of Emergency:

I understand every effort will be made to contact me. In the event I cannot be reached, I hereby give my
permission to the licensed health-care practitioner selected by the adult leader in charge to secure proper
treatment, including hospitalization, anesthesia, surgery, or injections of medication for my child.

 

 

___________________________            _______________                        ___________

Parent signature                                                 Phone                                            Date