Troop 258 will be attending Summer Camp at Camp Crooked Creek which is a part of the Old Kentucky Home Scout Reservation near Shepherdsville, KY. (Camp Crooked Creek 950 Terry Drive, Shepherdsville, KY 40165; Phone:(502) 955-9354)) July 18-24, 2004.All activities will be a part of the program as outlined in the leaders guide.Arrive at the Church at 9:30 AM on Sunday morning, 7/18/04.We will depart no later than 10:30 AM.Scouts should pack a lunch for the trip.We will return to MPC between 11:30 and 1:00 PM on Saturday 7/24/04.Scouts will call to be picked up once we return to the church.




1)   My son ______________________________ has permission to attend this yearís Summer Camp from 7/18/2004 through 7/24/2004.


2)   Will you be picking up your son on Friday evening 7/23/04 from Camp?†† No____Yes____

†††† How many people will be staying for Dinner on Friday 7/23/04?†† ________ ($4 each)


3) Has there been any change in the condition of your sonís health since his last Scouting trip?††† Yes_______ No_______ If yes list change______________________________________________


4) Is he taking medications? No____ Yes____ If so list ______________________________________


5) Does he have any medical conditions that the leaders need to be aware of?(Allergies, infections etc.)†† Please specify _______________________________________________________________


6) During the outing I can be reached at ______________________.If I am not available contact

†† ______________________________ at phone # _______________________


7) In the event I cannot be reached in an emergency, I hereby give permission to the physician selected by the leaders in charge to secure emergency treatment for my child named above



†††† _____________________________________________________

††† Parent or guardian signature and date