TROOP 58 BOY SCOUTS
Cumberland North Yarmouth
Permission Slip, Zealand Falls (AMC Hut) Trip
When: Saturday, December 11 - Sunday, December 12, 2004
Where: Hike up to Zealand Falls AMC hut.
Cost: Camping: $23.00 per person. We have spaces for 16 people.
Food: $ 8.00 per person, includes dinner on Saturday, breakfast and lunch on Sunday.
Total Fee: $31.00
(Gas: $ 5.00 unless traveling with own family. Adult cost will not include gas fee.)
Return this portion with payment No Slip, No Trip
Zealand Falls AMC Hut
Saturday, December 11 - Sunday, December 12, 2004
____________________________ (scout) has my permission to participate in all aspects of the above listed outing, as well as other related items that may arise on the agenda, with Troop 58 BSA. I realize there may be activities that can result in injuries. I give my permission to the representatives of Troop 58 to render any and all medical assistance they deem necessary. (This serves as permission to render medical treatment.)
Signed: _____________________________ Phone: __________________
Adult Participation: I will attend and drive __________________________
I will attend but will not drive ____________________________________
Driver's License number: ________________________________________
Vehicle Type and Year: _________________________________________
Vehicle Plate Number: _________________ Seatbelts: ________________