Permission Slip

PEOPLE IN CHARGE: John McCarthy

ACTIVITY: Ojibwas District Fall Camporee

TIME AND DATES:Friday-Sunday, October 8-10,2004

WHERE: Camp Kiwanis, 676 W Dansville Road, Mason, Michigan 48854

PHONE: (emergency only!) 517 676-6101 (Camp Ranger)

MEET AT: Olivet Baptist Church, Friday, October 8, 5:30 p.m.

PICK UP: Olivet Baptist Church, Sunday, October 10, 1:00 p.m.

ON THIS OUTING WE WILL BE: camping in tents at Camp Kiwanis in Mason on Friday and Saturday night, and participating in camporee activities on Saturday.

COSTS: $20.50 for meals and program

SPECIAL INSTRUCTIONS: Wear your Boy Scout shirt, if you have one. Dress according to the weather.

EACH PERSON WILL BE RESPONSIBLE FOR BRINGING THEIR OWN PERSONAL GEAR AND FOR TAKING CARE OF IT PROPERLY.

THIS PERMISSION SLIP AND THE TOTAL FEE OF $20.50 IS DUE BY TUESDAY, OCTOBER 5, 2004.

" -------Cut--------keep top portion---------return bottom portion--------cut---------- "

I GIVE PERMISSION FOR MY SON TO JOIN TROOP 272 ON THE FOLLOWING ACTIVITY: ___________________________________________

ON THIS DATE: ____________________________________________________

SIGNATURE OF PARENT OR GUARDIAN: ____________________________

I, ________________________________________________ (print scout’s name)

PROMISE TO OBEY THE SCOUT OATH, LAW AND OUTDOOR CODE.

SCOUT'S SIGNATURE: ____________________________________________

IN AN EMERGENCY, (name) _______________________________________

CAN BE REACHED AT THIS PHONE NUMBER ______________________

In case of Emergency, I understand every effort will be made to contact me (if an adult, my spouse or next of kin). In the event I cannot be reached, I hereby give my permission to the physician selected by the adult leader in charge to secure proper treatment, including hospitalization, anesthesia, surgery, or injections of medication for my child (or for me, if an adult).