Pack 72 Permission form for Cub Scout/WeBeLoS outing
Our Den / Pack is planning an outing to ___________________________________________________________________________
on ___________________________________.
The itinerary for the trip will be:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
You and your son will need to bring: ______________________________________________
The cost is $_____________ per person / scout.
Please fill out the following information and return to me no later than _________________
Along with any fees that are due. Make checks payable to PACK 72 and write down the activity in the MEMO section of your check.
Scout name: __________________________________________________________________
Parent(s) name: _______________________________________________________________
Sibling(s) (if allowed on this trip): _________________________________________________
I will be driving (
circle one) YES NO I need to ride with someone (circle one) YES NOI will take other passengers in my vehicle (
circle one) YES NOMy vehicle can hold ________ people safely and all will have seatbelts available to them.
My plate number & state are: ___________________________________
I give my permission for my son to attend the above outing. I understand that if I do not attend this trip with my son that I do not hold Pack 72 or any of its adult leaders liable for any injuries sustained while on this trip. My medical insurance information will be given to my son's leader along with a permission note, written in my hand, for any emergency medical procedures should they be needed.
Signature: _____________________________________________
Date: ______________________________