August 2017Campout Permission Slip
When: Saturday, August 5, 2017 – Sunday August 6, 2017
Where: Broken Bow, OK (approx 3 hours northeast)
What:18-mile overnight Kayak Trip
Cost:$95 per Scout or Adult
Departure Time: Meet at Riverside @ 6:00 am on Saturday, August 5
Return Time: Sunday, August 6 between 7pm and 8pm
NOTE: Check website for any adjustments to Departure and Return Times!
- Eat breakfast or bring sack breakfast before arriving on Saturday morning
- Arrive in Class A uniform
- Be prepared! – Bring weather appropriate clothing & other supplies
- SUNSCREEN, HAT, WATER SHOES RECOMMENDED
- WEAR A SHIRT WITH SUNBLOCK
- TOPS OF FEET AND THIGHS GET SUNBURNED ON CANOE TRIPS
THIS IS A KAYAK TRIP ONLY.
YOU MUST BE COMFORTABLE KAYAKING IN A RIVER BY YOURSELF.
YOU MUST BE A SWIMMER.
Deadline to sign-up: Monday, July 31
**********SPECIAL NOTE*********
Please call Mr. Alexander if you unexpectedly CANNOT attend the campout
972-880-1875
**********SPECIAL NOTE*********
Return the second page of this form along with your payment
Event:August 5-6, 2017 Kayak Campout
Scouts Name:
My son ______has my permission to attend the above event and to be transported by the Scoutmaster or his designee. I understand that there will be a minimum of two adult leaders at all times during the activity. I will arrange for my son to be picked up after the activity and ensure that he has the proper clothes, equipment, and money necessary for this activity. I also certify that my son can meet the health and physical fitness requirements of this trip/activity. He does not require any medication, special food or special needs unless specifically described below. Medicine will be provided prior to departure.
Medication or special food needs: (Please write N/A if none)
______
______
Allergic reactions: (Please write N/A if none)
______
______
Special Needs: (Please write N/A if none)
______
______
In Case of Emergency:
I understand every effort will be made to contact me. In the event I cannot be reached, I hereby give my permission to the licensed health-care practitioner selected by the adult leader in charge to secure proper treatment, including hospitalization, anesthesia, surgery, or injections of medication for my child.
______
Parent signature Emergency Phone Numbers
______
Date
I will attend event as an adult leader. Yes No
Name of Adult: ______
I will attend event as an adult leader and can drive*. Yes No
I will not attend but will be willing to drive on Friday* (if needed)YesNo
I will not attend but will be willing to drive on Sunday* (if needed)YesNo
*If willing to drive please complete the following vehicle info
Vehicle Information for Drivers of Troop 807
Owner's NameYear Make
Make
Model
# of Seatbelts / Passengers
TX DL #
Public Liability Insurance Coverage
Each Person (in $100k)
Each Accident (in $100k)
Property Damage (in $100k)
Notes:
3 hours, 186 miles
River Rats Canoe Rental
Fred 580-236-1099
Credit card reservation by Carl Nemec
$80 rental cost per canoe
$2.50 camping at Wakefield Landing cost per camper
$20.41 estimated cost for fuel and food per camper