BSA TROOP 58 Permission Slip

Troop Overnight to Carter's Notch


When:   Saturday and Sunday, March 4-5, 2006
Where:  Carter's Notch, New Hampshire
Meet:    Wescustogo Hall, North Yarmouth, Departure Time TBD
Payment: $40.00 per person includes housing, food and transportation.
Make checks payable to BSA Troop 58.

Permission Slip and Payment Due: Monday, February 13, 2006


Return this portion with payment No Slip, No Trip

BSA TROOP 58 Permission Slip

What:    Troop Overnight to Carter's Notch, New Hampshire
When:   Saturday and Sunday, March 4-5, 2006
Where:  Carter's Notch, New Hampshire
Meet:    Wescustogo Hall, North Yarmouth, Departure Time TBD
Payment: $40.00 per person includes housing, food and transportation.
Make checks payable to BSA Troop 58.

Permission Slip and Payment Due: Monday, February 13, 2006

Scout Name(s): __________________________________________________________________________
has permission to participate in all aspects of the above Boy Scout activity with the leaders of BSA Troop 58.
I understand the risks and dangers involved, and will not hold the leaders of 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)

Adult Name (print):________________________________________


_____ Yes, I will go, drive, and help. # of Seatbelts:__________________

_____ No, I'm not going, but I can drive. # of Seatbelts: __________________

Year/Make/Model: ____________________

Me. Lic #: ___________________________