Troop 58 Event Permission Slip
Activity: Fishing Trip Campout
Drop off Time:5:00PM SharpDate: Friday, October 17, 2014Place: Walmart - Carl Boyer Dr.
Pickup Time: 2:00 PM (approx.)Date: Sunday, October 19, 2014Place: Walmart - Carl Boyer Dr.
Troop 58 will be departingFriday for a weekend of camping & fishing, up Hwy 395 to the town of Big Pine. Please have your scout arrive on time and has eaten dinner. We will be camping at Baker Creek Campground just north of Big Pine. Scouts will need to bring their own fishing gear, Anyone over the age of 16 will need a fishing license. Scouts should also bring cool weather gear, sack lunch for Saturday, and water to drink. Saturday breakfast, dinner,and Sunday breakfast are included in the cost and will be group meals. The troop will be stopping on the way home for lunch on Sunday, please provide your scout with lunch money for the return trip. If your scout is going for the Fishing Merit Badge please have them contact the merit badge counselor prior to this trip.Uniform is Class Acoming & going. Class B on Saturday. Cost is $30.00 per person. Again this includes Saturday breakfast & dinner, Sunday breakfast, and gas. Saturday lunch is on your own with a sack lunch. Sunday lunch will be on the road $ is needed.
Any questions, please contact Mr. Oliver (661)252-2082
Emergency Contact:Robyn Fennessy (661) 297-6188
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Scout and Adult Participation – Fishing Trip Campout
Participant (s) (please print)______Phone # ______
Cost: $30.00 per person. Scouts Attending: ______+ Adults Attending: ______= Total ______
I will drive YES or NO. I have room for myself and _____ other people. I have insurance. Vehicle Year ____ Make/Model ______CDL ______(Minimum Insurance is $15,000/$35,000)
PARENTAL STATEMENT
Scout Name: ______Patrol: ______Emergency Telephone # ______
Is it necessary to restrict the scout’s activities for medical reasons? (Circle one)YesNo
If yes, please explain. ______
Does the scout take medications or require special care (circle)YesNo
If yes, please explain:
Hold Harmless Agreement
I understand that participation in Scouting activities involves a certain degree of risk and can be physically, mentally, and emotionally demanding. I have carefully considered the risk involved and have given consent for myself or my child to participate in this activity. I also understand that participation in this activity is entirely voluntary and requires participants to abide by applicable rules and standards of conduct. I release the Boy Scouts of America, the local council, the activity coordinators, and all employees, volunteers, related parties, or other organizations associated with the activity from any and all claims or liability arising out of this participation. In case of emergency involving my child, I understand every effort will be made to contact me. In the event I cannot be reached, I hereby give my permission to the medical provider selected by the adult leader in charge to secure proper treatment, including hospitalization, anesthesia, surgery, or injections of medication for my child. Medical providers are authorized to disclose to the adult in charge examination findings, test results, and treatment provided for purposes of medical evaluation of the participant, follow-up and communication with the participant’s parents or guardian, and/or determination of the participant’s ability to continue in the program activities. I have discussed with my son the importance of following safety rules. He understands that if he chooses not to follow the rules that he will be excluded from this event and I will be contacted to come and take him home
Parent or Guardian’s Signature: ______Date: ______
Permission Slip and Money due by Monday Oct 13, 2014
Troop 58 Event Permission Slip