Troop 388 Permission / Release Form

This form has three (3) parts. Please complete all three parts.

1. Authorization to attend

My son (or ward), , has my permission to participate in the Troop 388 adventure: Kayaking, departing Friday, May 16, 2014 at 4:15pm from Greystone Baptist Church and returning Sunday, May 18, 2014 around 12:30pm to Greystone.

I understand that this trip will involve, but may include more of: Kayaking and beach camping. I have read, reviewed, and understand the activity's details, which are available online.

In case of injury or illness, I authorize Troop 388 to administer emergency first aid and/or seek all necessary medical attention for my son as may be indicated by my son's condition or the advice of trained medical personnel. I agree that I have completed and kept up-to-date my son's Emergency Medical Treatment record in the Troop's files, and I further acknowledge that this information may be used to administer emergency first aid.

In such a case, I understand that Troop 388 will make every effort to contact me as soon as possible at the emergency contact information I list in section 2, below.

I agree to indemnify and hold harmless the leadership of Troop 388 (including, but not limited to, Scoutmasters, Assistant Scoutmasters, Junior Assistant Scoutmasters, Troop Committee members, and adults who may be participating in or providing assistance for the adventure) and Greystone Baptist Church in the event of injury or illness resulting from my son's participation in this adventure.

I understand and agree that Troop 388 may request a medical clearance or a doctor's note prior to confirming my son's attendance in the adventure.

2. Emergency contact information

Please list the name and full contact information for the person whom we should contact in the event of injury or illness during the times listed above.

If an itinerary for the emergency contact person during the times listed above is available, please attach a copy.

3. Activity fees

To cover additional costs the Troop will incur for my son to attend this adventure, including but not limited to, transportation costs, campsite/lodging costs, equipment rental, and patches, T-shirts, and paraphernalia, I agree to pay $50 per person, includes kayak rental, camp fee, and gas but not food. on or before the departure time listed above.

I understand that failure to pay the activity fees indicated above may prevent my son from attending the adventure and may result in partial or total forfeiture of any deposit I may have paid.

Printed Parent/Guardian Name:

Signed:

___________________________________________

Dated:

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