Permission Slip Form - Boy Scout Troop 276 printable pdf download

PERMISSION SLIP

As the parent or legal guardian of _________________________ , I hereby give my

permission for this child to participate in an outing with Troop 276.

Activity: ____________________________

Location: _____________________________

Departure Time: ______________________________________

Date: ________________

Return Time: ________________________________________

Date: _______________

I understand that participation in Scouting activities 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 these activities. I understand that participation in these activities 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.

I approve the sharing of the information on this form with BSA volunteers and

professionals who need to know of medical situations that might require special

consideration for the safe conducting of Scouting activities.

In case of an emergency involving me or my child, I understand that every effort will be

made to contact the individual listed as the emergency contact person. In the event that

this person cannot be reached, permission is hereby given to the medical provider

selected by the adult leader in charge to secure proper treatment, including

hospitalization, anesthesia, surgery, or injections of medication for me or 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 with the participant's parents or guardian, and/

or determination of the participant's ability to continue in the program activities.

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 Form - Boy Scout Troop 276