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