PARENT PERMISSION FOR “LA HẦU LA – HUONG VIET CAMP” ACTIVITY

LEADERS must obtain the written permission of the parent or guardian of each child planning to participate in the activity below. Children without written permission cannot participate in the activity. At least one adult must be with his/her children at all times due to safety issues.

Activity Planned LA HẦU LA – HUONG VIET CAMP

Destination làng A Di Đà Indio, 84115 INDIO BLVD, INDIO, CA 92001 Method of Transportation Self

Activity will start on ____12/27/2013______Time___12:00 ______p.m.

Activity will end on ____12/29/2013______Time ___3:00______p.m.

Your child should have money for the following: Trans. $______Food$ ______other$ ______Total $ __0___

Free for All campers.

Activities will include the following: Food, Drinks and Program Activities.

Please bring : a pair of sneakers to participate in the group activities.

If there are any changes in plans while the event is in progress, the parent/guardian will contact this person:

Đại Đức Thích Tuệ Định (760-718-9674)

PLEASE CUT THE FORM BELOW AND RETURN TO THE LEADERS BY (DATE): 12/20/2013 or at check-in

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My child ______has permission to participate in LA HẦU LA – HUONG VIET CAMP at làng A Di Đà Indio, 84115 INDIO BLVD, INDIO, CA 92001 from 12:00 PM on 12/27/2013 to 03:00 PM on 12/29/2013.

My child is currently a registered member of BSA GSUSA No

I hereby waive and release Tam Nguyen Temple and all individuals, staff members or volunteers working in connection with LA HẦU LA – HUONG VIET CAMP activities from any and all possible claims for injury to person or property which might arise in connection with my child’s participation in activities sponsored or provided by you.

I do not hold the Temple responsible for any accident or illness which might occur and authorize the adult in charge, should it be necessary, to secure the service of a doctor at my expense. (Parent will be notified in case of an emergency.)

During the above activity, I ______will will not stay and supervise my children at all times.

Parent or Guardian Signature______

Emergency contact that can be reached by telephone during the event, if the parent is unable to be reached:

Name Home phone # Work Phone #