(date of notice)

BSA TROOP 58 Trip Notice

What: (Name of trip)
(Description of trip)

When: (dates and times)
(Details of leaving/returning, eat before arriving, etc.)

Where: (Location, including directions if needed)

Equipment: (General description and any special items)

Payment: ($total $fee & $food) Make checks out to BSA Troop 58

Keep this portion on your Refrigerator
====================================================================================

Return this portion with payment by: (due date)
"No Slip, No Trip."

BSA TROOP 58 Permission Slip

What: (same as above)
When: (same as above)
Payment: (same as above)

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 contact & phone: __________________________________________________________________

Signed: _____________________________________________________ Date: _______________________
(parent or guardian)

Print Adult Name: ___________________________________________________________________________


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

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

Year/Make/Model: ____________________ No. Seatbelts:_____ Me. Lic #: _____________

Additional Info: