I hereby give permission for my son __________________________ to participate in Boy Scout Troop 58 trips and any activities that may be undertaken on route. If I cannot be reached in an emergency, I give permission to the physician selected by an adult scout leader to hospitalize, secure anesthesia, order injections or provide other necessary medical/surgical care. In addition, I give permission for the adult Scouts to transport him to and from the events by automobile. Any significant medical conditions which might affect my son’s participation in these activities, or emergency care, are noted below:

I hereby give permission for my son __________________________ to participate in Boy Scout Troop 58 trips and any activities that may be undertaken on route. If I cannot be reached in an emergency, I give permission to the physician selected by an adult scout leader to hospitalize, secure anesthesia, order injections or provide other necessary medical/surgical care. In addition, I give permission for the adult Scouts to transport him to and from the events by automobile. Any significant medical conditions which might affect my son’s participation in these activities, or emergency care, are noted below: