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TROOP 575 ACTIVITY PARTICIPATION APPROVAL FORM

                                                                      has my permission to participate in all activities

planned and approved for                                                                                                           .

to be held at                                                             on                                                           .

Please state on the back of this form any limitations in participation or changes in health that Adult

Leaders should be aware of.

                                                                                                                                            .

Adult Leader    Parent.

                                                                                                        _
Telephone number(s) where you can be contacted during the activity.


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