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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.

 

Date:                                                

 

Location:                                                  

 

Time/Place of Departure:                                         

 

Time/Place of Return:                                            

 

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)

 

 

 

 


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.

 

Date:                                                

 

Location:                                      

 

Time/Place of Departure:                                         

 

Time/Place of Return:                                            

 

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)