Permission Slip     

As the parent or legal guardian of _________________________ , I hereby give my permission for this child to         

participate in an outing with Troop 77.     

                                                                                       Location       

Departure Time:                              Date:   __/__/__               

Return Time:                                   Date:   __/__/__               

Activity:                                                                                   

I give permission to the leaders of the above unit to render First Aid, should the need arise. In the event of an           

emergency, I also give permission to the physician, selected by the adult leader in charge, to hospitalize, secure     

proper anesthesia, order injection, or secure other medical treatment, as needed.  

I further agree to hold the above named unit and its leaders blameless for any accidents that might occur during this

outing except for clear acts of negligence or non-adherence to BSA policies and guidelines.

In case of emergency, I can be reached by phone at ____________________ or ____________________.   

If I cannot be reached, please contact _________________________ at ____________________.   

Signed: ______________________________  Date: _______________      

                       (Parent or Guardian)