Boy Scout Troop 95 Parent Permission Slip
Troop 95 is planning: Cabin camping at Apple River Canyon
Date:Jan 30 – Feb 1, 2009 Location:Apple River, IL
Departure from: Christus Victor Departing Time: 6:00 pm
Return to: The parking lot across from Christus Victor Time:12 noon
The Cost will be $20 per Scout
Person in Charge will be: Dave Tiritilli
If you must contact your son on this trip, call 847-544-8893
___COMPLETE SCOUT UNIFORM _X_SCOUT SHIRT ONLY___CLASS “B”
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Please detach and return this lower half with PARENT SIGNATURE and SCOUT SIGNATURE along with fees to Scout Leader prior to outing.
My son, , has my permission to go with Troop 95 onJan 30 – Feb 1, 2009, to Apple River Canyon in Apple River, IL .
In consideration of services donated by others, I will hold harmless, the Trained Registered Leaders of Boy Scout Troop 95 who acted reasonably under circumstances, in case of accident or illness. I am familiar with details of the activity and have provided my son with the necessary funds and equipment. I will be sure that he does not attend if he is not in good physical condition on that day. He may have emergency medical attention at my expense, should he become ill or injured on the outing.
Medical Treatment Form on file with Troop Y_____ N_____
Medication Authorization Form on file with Troop Y_____ N_____
Medications are being sent on this outing Y_____ N_____
IF YES fill out Medication Disbursement Instruction Form on back.
During the activity, I may be reached at (_____)______
(Phone)
If I cannot be reached, please contact______
(Name)
______(______) ______
(Address)(Phone)
___ I will not attend with my son
___ I will drive and can take ______passengers ___ I will pick up only and can take _____ passengers
My son will remain at this activity through the Troop's return, unless prior Scoutmaster approval has been given.
______
(Parent or guardian)(Date)
TROOP 95 Medication Disbursement Instruction Form
INSTRUCTIONS
1. A Medication Authorization form must be on file with the Troop
2. This Medication Disbursement Instruction Form must be filled out for each outing
3. Medication must be in a container appropriately labeled by a pharmacy, physician or in the original packaging if the medication is of the “ over the counter” variety.
4. Attach additional pages if more than one medication is sent.
5. Medication(s) and Instruction form(s) are to be given to a Troop trained Adult Leader prior to departure for the outing.
Scout Name:______
Medication:______Dosage ______
Time medication is to administered: ______
Period of time medication is to be administered: From______to ______
DateDate
Anticipated Results______
Any Special requirements (Refrigeration required, must be administered with meals or with milk, etc.):
______
Special Instructions for Inhalers Only:
Scout may carry inhaler at all times: YES______NO ______
If yes, it is recommended that your scout inform an adult every time the inhaler is used.
Parent’s signatureDate