12- APR-00

BSA TROOP 58 Permisison Slip

What: Maine Rock Gym - Climb the Walls!

When: Monday, April 24, 6:30-9:00

This is in lieu of the regular meeting. There will not be a formal organizaional meeting.

Where: Maine Rock Gym - Marginal Way, Portland 870-6370.

Get there on your own, you may wish to work out car pooling ahead of time.

Equipment: You may want to wear/bring shorts.

Payment: $11.00 per scout - No Adults

There are only 30 Slots - To get on the list Return the following items to Mr. Bucsko:

Troop Permission slip (signed)

Rock Gym Waiver (signed)

$ 11.00

Keep this portion on your Refrigerator

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Return this portion along with MRG Waiver and Payment to Rich Bucsko, PO Box 453, Cumberland Center, ME 04021

"No Slip & Waiver - No Trip."

BSA TROOP 58 Permission Slip

For: Maine Rock Gym

When: Monday, April 24, 2000

Payment: $11 due with permission slip - MRG Waiver also required.

Scout Name(s): _______________________________________________

has permission to participate in all aspects of the above Boy Scout activity with the leaders and parents of BSA Troop 58.

I understand the risks and dangers involved, and will not hold the leaders nor Troop 58 liable for any accident or injury which may occur during this activity. In the event of illness or accident in the course of this activity, I request that measures be instituted without delay as the judgment of Troop leaders or medical personnel dictates.

Your signature below is a commitment. If you sign up for a trip, and then find that you cannot go, remember that plans have been made to accommodate you, and payments have been made for reservations and supplies. We honor your word. Please honor your commitment by paying for your share of these expenses whether you go or not.

Emergency phone:_________________________________

Signed: ____________________________ Date ___________

(parent or guardian)