| Permission Slip |
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| 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). |
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| PEOPLE IN CHARGE: John D. McCarthy. Troop 111 is providing adult leadership for this event.
Troop 272 will not be providing transportation to and from this event. |
| ACTIVITY: YMCA Lock-In |
| TIME AND DATES: Friday, February 10 to Saturday, February 11, 2006 |
| WHERE: Parkwood Branch, YMCA,
2306 Haslett Rd., East Lansing, MI 48823 |
| PHONE: 517.332.8657 (Parkwood Branch, YMCA) |
| MEET AT: 8:00 p.m. Friday, Parkwood Branch, YMCA |
| PICK UP: 8:00 a.m. Saturday, Parkwood Branch, YMCA |
| ON THIS OUTING WE WILL BE: enjoying basketball, racquetball, swimming, games, pizza, pop and more! |
| COSTS: $12.00 |
| SPECIAL INSTRUCTIONS: Wear your Boy Scout shirt, if you have one. Bring swimming gear. |
| EACH PERSON WILL BE RESPONSIBLE FOR BRINGING THEIR OWN PERSONAL GEAR
AND FOR TAKING CARE OF IT PROPERLY. |
| THIS PERMISSION SLIP AND THE FEE OF $12.00 IS DUE BY:
Tue. 1/17/06 |
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