BSA TROOP 17-DENVILLE, NJ
ACTIVITY PERMISSION FORM
Permission is granted for our son________________________to participate in the
Please hand in this permission form along with a copy
of your most recent BSA medical form when you register for the trip.
The medical form should be
the most recent Class 1-2, Class 3 or Philmont medical form dated April 2001
or later. If the medical form is
older then April 2001, the Scout’s parent or Guardian must sign
and date the copy of the form to be handed in upon registration for the trip. A blank form is available at the Patriot’s
Path Council office (973) 361-1800.
|
NOTE: YOU MUST HAVE BOTH THIS PERMISSION
FORM AND THE MEDICAL FORM ON FILE TO SIGN UP. |
My son can attend the entire Washington DC camping trip. _________________________
My
son can only attend part of the weekend – from (when) ____________ to (when)
__________
Does
your son have any allergy, medical condition or medication that warrants
notification?
Yes________
No_________ If yes, please explain:________________________________________
_________________________________________________________________________________
I understand that all Scouting activities are conducted in the spirit of the Scout Oath and Scout Law. A Scout who in the opinion of the Troop leadership, does not live up to these principals may be requested to call his parents and have them bring him home.
As
the parent/guardian of the above Scout, I understand that my son will be
attending this scheduled activity with my full knowledge and permission. He may participate in all activities
programmed except as I may stipulate to the leaders in charge.
Further
if in the judgment of the Scout Leaders in charge, it becomes necessary to send
my son to a nearby hospital, physician, or dentist for diagnosis and/or
treatment, they have my full permission to do so.
I
give my full permission for my son to participate in all activities except as I
may have excluded in writing, and give my full permission to the medical
attendant in charge to hospitalize, secure anesthesia, or order injections or
surgery for my son should the need arise.
I as parent/guardian will assume full responsibility for such
arrangements including payment of expenses incurred and hold harmless the
Patriot’s Path Council, Inc, its servants, agents or employees as well as BSA
Troop 17-Denville and its servants, agents or employees from any and all with
respect hereto.
Parent/Guardian
Signature: ________________________________ Date: ___________________
Important:
Phone numbers where parent/guardian can be reach over the duration of
the camping trip:
Primary
(____) _____-______ Alternates (____) _____-______ (____) ______-_______