Teller Wildlife Refuge Field Trip

When:

Date: November 9, 2000

Location: Teller Wildlife Refuge, 1292 Chaffin Lane, Covalis MT.

Time/Place of Departure: 10:15am, John Schilling Residence, 3305 Jack Drive Missoula MT

Time/Place of Departure: 4:15, John Schilling Residence, 3305 Jack Drive Missoula MT

What we’ll accomplish:

Work toward BSA Outdoor Code & Community Service

What to bring:

Warm coat

Gloves

Hat

Rain Poncho

Extra pair of socks

Shoes/boots appropriate for weather

Your own cold lunch

Water bottle/Canteen

Backpack to carry your gear

Wear your Scout Uniform

Rake or shovel

SIGNED PARENT PERMISSION SLIP (SEE ATTACHED PAGE)

PERMISSION SLIP Unit: Pack 4996, Mullan Trail District

As the parent or legal guardian of , I hereby

give my permission for him to participate in an outing with Pack 4996.

Location: Teller Wildlife Refuge, 1292 Chaffin Lane, Covalis MT.

Time/Place of Departure: 10:15am, John Schilling Residence, 3305 Jack Drive Missoula MT

Time/Place of Departure: 4:15, John Schilling Residence, 3305 Jack Drive Missoula MT

I give permission to the leaders of the above unit to render First Aid,

should the need arise. In the event of an emergency, I also give

permission to the physician, selected by the adult leader in charge, to

hospitalize, secure proper anesthesia, order injection, or secure other

medical treatment, as needed. I further agree to hold the above named

unit and its leaders blameless for any accidents that might occur during

this outing except for clear acts of negligence or non-adherence to BSA

policies and guidelines.

In case of emergency, I can be reached by phone at ________________

or ________________. If I cannot be reached, please contact

____________________________________ at ____________________________.

Signed: _________________________________________ Date: ___________

(Parent or Guardian)