Permission Slip

PEOPLE IN CHARGE: John D. McCarthy and Gary Cunningham

ACTIVITY: Lake Michigan Outing

TIME AND DATES: Friday, July 9 thru Sunday, July 11, 2004

WHERE: P. J. Hoffmaster State Park, 6585 Lake Harbor Rd., Muskegon, MI 49441

PHONE: 231-798-3711 ( P. J. Hoffmaster State Park)

MEET AT: Olivet Baptist Church, 4:30 p.m., Friday, July 9, 2004

PICK UP: Olivet Baptist Church, 2:30 p.m., Sunday, July 11, 2004

ON THIS OUTING WE WILL BE: The main activities will be camping on Friday and Saturday night and swimming and hiking on Saturday. We will be camping at the organizational campground at P. J. Hoffmaster State Park.

INFORMATION FOR SUNDAY WORSHIP SERVICE: 10:00 a.m., Unity Reformed Church, 1521 Porter Rd., Muskegon, MI, (231) 798-2476

COSTS: $20.00

SPECIAL INSTRUCTIONS: Wear your Boy Scout shirt, if you have one. Dress according to the weather. Bring a sack lunch for the trip to our campsite on Friday evening. Bring swimming gear and a compass, if you have one, for hiking.

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 $20.00 IS DUE BY: TUESDAY, JULY 6, 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).