THIS SHEET MUST BE GIVEN TO AN ADULT LEADER

SCOUT PROMISE: In return for permission to accompany Troop 14 on this outing, I promise to follow the Scout Oath and Law with regard to my personal conduct, the health and safety of myself and other Scouts and guests, and the Boy Scouts of America approved camping practices. If during an outing I become unmanageable and refuse to follow the directions of an adult or senior Scout, my parents will be called to pick me up NO MATTER WHAT TIME OF DAY OR NIGHT and I will not be permitted to attend further outings until I, have met with the Troop Committee.

SIGNATURE OF SCOUT: __________________________________ DATE: _________________

EVENT:_______________________________________________________________________

I will be riding in _________________________________'s car to and from the event.

____ This is an overnight camping event and I will be sleeping in _____________'s tent.

PARENT PERMISSION: Scout ____________________________ has my/our permission to go on this outing scheduled for __________________. The above Scout is deemed in good physical condition unless otherwise noted below. Adult leaders, all over 21 years of age, will supervise all activities associated with this trip. In case of illness or accident in the course of such activity, I request that measures be instituted immediately as the judgment of medical personnel dictates. I understand that participation in the activity involves a certain degree of risk. I have carefully considered the risk involved and have given consent for myself or my child to participate in the activity. I understand that participation in the activity is entirely voluntary and requires participants to abide by applicable rules and standards of conduct. I release the Boy Scouts of America, the local council, the activity coordinators, and all employees, volunteers, related parties, or other organizations associated with the activity from any and all claims or liability arising out of this participation.

In case of emergency involving my child, I understand every effort will be made to contact me. In the event I cannot be reached, I hereby give my permission to the medical provider selected by the adult leader in charge to secure proper treatment, including hospitalization, anesthesia, surgery, or injections of medication for my child. Medical providers are authorized to disclose to the adult in charge examination findings, test results, and treatment provided for purposes of medical evaluation of the participant, follow-up and communication.

ALLERGIES, MEDICATIONS, OR PHYSICAL LIMITATIONS ________________________________

IN CASE OF EMERGENCY, NOTIFY: ___________________________ PHONE: _____________

Total number of people in family attending: _______________

We will be driving, total number of seatbelts in car: ____

SIGNATURE OF PARENT: ____________________________________ DATE: ________________