Camping:

Version 1 4/22/2005

The State Police are organizing a Fall of 2007 Boy Scout

Camporee at the Sea Girt Army Reserve Center. This

camporee happens once every three years. In order to

participate, the Troop has been required to place a deposit of

$25 per camper. Since space is limited we are asking that

return $25 to the Troop to secure a spot for each camper.

waiting list. Unfortunately this is a very popular event and to ensure full participation,

Jersey Shore Council that runs this event with the State Police secure deposits 11 months in

advance.

the deposit and issue a refund.

Any questions, please see Rolf Kamp or Don Eddy.

Home Phone: ___________________

Cell: ___________________

Signed: ________________________________ Date: ___________________

Received by: ________________________________ Date: ___________________

agree to adhere to them. It is expected that all of our Scouts will do their best to: 1) live up to the Scout Oath and Law

and the Outdoor Code; and 2) participate in the Scouting program offered by the Troop. The Scoutmasters and the

Troop Committee, reserves the right to apply appropriate discipline (within the guidelines of National BSA policy) if

the behavioral situation warrants it. This may include a parent picking the scout up from an activity, no matter where

the troop is. At all times the Guide to Safe Scouting and the Youth Protection Guidelines will be followed.

Version 1 4/22/2005

1. I, the undersigned, give my son, named above, permission to attend the activity outlined above and its affiliated

activities. I give him permission to fully participate in all programs. I understand that in order to attend he must

submit this permission slip and accompanying medical form completed correctly (if not currently on file with Troop

50). I understand that the medical form must be signed and completed by a physician indicating that the camper has

undergone a physical in the past 12 months.

2. I give permission to the leaders of Troop 50 or personnel selected by the leader in charge, to render First Aid,

should the need arise. I understand that in the event of an illness or injury in the course of programs, every effort

will be made to contact me. If in the event I can't be reached, or in the event of an emergency, I also give permission

to the physician or dentist, selected by the adult leader in charge, to provide, dental or surgical diagnosis or treatment,

or secure other medical or dental treatment, as needed for my son.

3. I understand that my son may be eligible to participate in a variety of special programs. I hereby give permission

for his participation in any of these programs. These activities can include, but are not limited to, mountain bicycle

rides, backpacking treks, rock climbing, rafting, wilderness camping, sport competitions, rifle shooting, and horse

riding. I understand that he needs to be in adequate physical condition for participation in these activities

4. I do hereby grant permission for the use of pictures, video or likeness of my son, taken during the activity, to be

used for promotional purposes.

5. I further agree to hold harmless the above named unit(s) and their respective agents and volunteer leaders, from

any and all liability arising from accident or any cause whatsoever during the referenced activity, including but not

limited to any mishap associated with transportation to, from, or during, this activity except for clear acts of

negligence or non-adherence to BSA policies and guidelines.

I have carefully read and understand all sections of this permission slip.

Allergies: ________________________________________________________________________

Medications: ______________________________________________________________________

Restrictions: ______________________________________________________________________

Special Instructions:________________________________________________________________

Home Phone: _________________ Cell: ___________________ Pager: ______________________

In case of emergency contact: _____________________________ Phone:_____________________

Signed: ______________________________________________ Date: _______________________

Received by: __________________________________________ Date: _______________________

agree to adhere to them. It is expected that all of our Scouts will do their best to: 1) live up to the Scout Oath and Law

and the Outdoor Code; and 2) participate in the Scouting program offered by the Troop. The Scoutmasters and the

Troop Committee, reserves the right to apply appropriate discipline (within the guidelines of National BSA policy) if

the behavioral situation warrants it. This may include a parent picking the scout up from an activity, no matter where

the troop is. At all times the Guide to Safe Scouting and the Youth Protection Guidelines will be followed.

Version 1 4/22/2005

I, ___________________________, parent or guardian of ________________________________,

my son on all outings of the troop in which he may participate. Although specific brands are listed

we reserve the right to substitute brands or equivalent generic. By authorizing the dispensing of

for your son. If your son is having a problem he needs to immediately notify an Adult Leader.

the age of the youth for treatment of diarrhea. This medication will not continue to be

dispensed if symptoms persist for more than 24 hours, if symptoms are accompanied by

other abdominal pain, or excessive tenderness in the abdomen.

when youth has NO listed (on Class I, II, or III BSA health forms) record of allergic

has not provided specific medication.

reactions.

bites.

with/without menthol.

PLEASE NOTE: this form is not intended to replace the Boy Scout required consent to treat forms.

Instead, it is intended to advise you, the parent or guardian, that these non-prescription medicines

may be administered to your son. Your signature below is your acceptance of these conditions and

dosages whereby the medication might be administered.

In the event these medications are NOT acceptable for your child, you, as parent ACCEPT complete

each activity in which your child participates.

I have read the criteria above and understand.

__________________________________________ Date: _____________

Signature of parent or guardian

____________________________________

please print your name here