Troop 258 will be going to Stanley Brown’s (Colin Doherty’s Grandfather) property (near Winchester, Ohio) Oct 11-12, 2003. The troop will be leaving the Montgomery Presbyterian Church at 8:00 a.m. Saturday morning and returning between 12:00pm to 2:30 p.m. on Sunday. Your scout will call once we return to the church. The scouts will be camping in tents on the premises. This will be a set up camp and stay at location weekend. As this is a wooded area, please ensure that long pants are brought along. We will be participating in many Scouting activities so it will be a great opportunity for the Scouts to work on Advancements. The cost for each scout will be determined once the food is purchased.
1) My son ____________________________________ has permission to participate on the Adams County Campout on 10/11/2003 through 10/12/2003
2) Has there been any change in the condition of your son’s health since his last Scouting trip?
Yes_______ No_______ If yes list change__________________________________________
Is he taking medications? No_________ Yes_________ If so, list:
3) Does he have any medical conditions that the leaders need to be aware of? ( allergies, infections etc. )
Please specify: ________________________________________________________________________
4) During the outing, I, _______________________________can be reached at
___________________________ If I am not available contact:
____________________________ at phone # _______________________
5) 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