As the parent of legal guardian of
________________________________________________________
I hereby give my permission
for him to participate in an outing with
BSA Troop 762.
|
Date: |
___________________________________________ |
|
Destination: |
___________________________________________ |
|
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 injections, 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:
___________________________ [home/work/cell/pager]circle
or ___________________________ [home/work/cell/pager]circle
If I cannot be reached, please contact
________________________________ at ____________________.
Signed: ____________________________Date:____________
(Parent or Guardian)