TROOP - 3 PERMISSION SLIP

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I give permission for my son, __________________ , to go with Troop 3 to: __________________________________________________________________________.

_________________________________ / _________________
(Signature of Parent / Date)

Emergency Treatment: I give permission for the Boy Scout adult leaders to authorize emergency treatment for my son should it become necessary.

In the event of an emergency, I can be reached by telephone / pager / other

Phone # (____)________________ Alternate Phone #(____)_______________.

Pager # (____) ________________ Cell Phone # (_____)_________________.

WORK PHONE NUMBER (____) ________________________.

Email Address________________________________________

_________________________________ / _________________

(Signature of Parent / Date)

Doctor’s Care / Medication: Please record if your son is under a Doctor’s care or taking medication for any reason, do not leave blank, write "none" if this does not apply :



Transportation:

I have ____________seat belts and can transport __________scouts

I can transport: TO THE EVENT________FROM THE EVENT_________

I can attend the event ___________I can not attend the event____________

Driver’s Name ______________________Drivers License #_____________________

Kind, year, and make of vehicle ______________________________________________