PERMISSION SLIP

As the parent or legal guardian of ______________________, I hereby

give my permission for him to participate in an outing with Troop 688.

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 furthur agree to hold the above named

unit and it's leaders blameless for any accidents that may 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)

rev 6/01