Scoutmaster – Joe Harris / Committee Chair – Dean Hemphill
TROOP 188 PARENTAL CONSENT FORM
I hereby give my consent for Scout to take part in Boy Scout Troop 188 campouts and outings which will consist of automobile travel. This consent form is in effect during any Boy Scout functions that Troop 188 takes part in from January 1, 2017 to December 31, 2017.
In the case of an emergency, I understand that every effort will be made to contact me, or the persons listed below on this form. In the event that I cannot be reached, I hereby give consent to the adult leaders listed below to seek medical care for my son. I hereby give consent to the physician selected to give necessary emergency medical care or treatment, which may include surgery, hospitalization, anesthesia, or injections of medications. I also guarantee the payment of said care or treatments.
I give my consent to the adult leaders listed below to make all decisions deemed necessary by them concerning the health and welfare of my son during outings. These leaders have all gone through the training as deemed necessary by the Boy Scouts of America. I will assume all liabilities occurring as a result of any treatments which are made on my son's behalf.
LEADERS RECEIVING CONSENT: Joe Harris - Scoutmaster, Mark Noll - Asst. Scoutmaster, Steve Bruder – Asst. Scoutmaster, John Krogh – Asst. Scoutmaster, Dean Hemphill - Committee Chair.
My Insurance Company is:
My Policy Number is:
My home and business phone #
Please list any activity the Scout should not take part in
Any allergies to medications, food, plants, or insect bites.
______
Person to contact or
Phone Number or
Relationship to Scout
Signature of Parent or Guardian: Date:
PLEASE COMPLETE PHOTO RELEASE FORM ON OTHER SIDE
TROOP 188 – Photo Release Form – 2017
Troop 188 participates in a number of exciting activities throughout the year. The publication of articles and photos in the Ankeny section of the Des Moines Register (print and online editions) is a great way to highlight the achievements of our scouts and promote the positive scouting message.
When publishing individual or small group pictures, the Des Moines Register requires the first and last names of individuals. To ensure we respect your privacy concerns, we ask that all scouts have a signed photo release form. Please check one response below indicating your permission to publish your scouts first and last accompanying a published photo.
______Yes, my child's full name may be published (print and online edition) along with photographs in the Ankeny section of the Des Moines Register.
______No, my child's full name may not be published (print and online edition) along with photographs in the Ankeny section of the Des Moines Register. Note - group photos may still be published without any inclusion of names.
Signature of Parent or Guardian: Date:
PLEASE COMPLETE PARENTAL CONSENT FORM ON OTHER SIDE
http://www.troop188ankeny.org/