Troop 583 Permission Slip

As parent or legal guardian of ______________________, I hereby give my permission 
for him to participate in the Troop 583 outing listed below. I give the leaders of 
the above described activity 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 the adult 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 at these numbers, please

contact ______________________________ at phone #_______________________


Signed:__________________________________ Date:_______________________
                  Parent or Guardian

Medical Insurance: Company___________________Policy #__________________

 Event: ________________________
          date _______

>>>>> Please return this half with $__.00 for meals <<<<<<
>>>>>  Turn it in by ______ at troop meeting   <<<<<<

------------ Parents retain this part (below)----------

Troop 583
Permission Slip

event ____________

Departure:  _________

Return:  ______________		

Emergency Contact # for the weekend:  Jose A. Gamez  956-451-9405
                                      Debbie Jackson 956-739-3941 
                                      Gerard Mittelstaedt 956 648-8290

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