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: Campout at Camp Perry North of Rio Hondo, TX 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
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