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EVENT: White
Water Rafting ACTIVITY: Raft trip on
the Leigh river
DEPART: Friday , June 3 2011 at 5:00PM RETURN: Sunday, June 5, 2011 at 12:00PM DESTINATION: Camp Alpine BRING: Bag diner, hat, coat, gloves, hiking boots, raingear, sleeping bag COST PER SCOUT: $25.00 PERMISSION SLIP REQUIRED FOR EACH YOUTH PARTICIPATING REGARDLESS IF PARENT IS ATTENDING. PARENTS ARE ALWAYS WELCOME. Bring: Rain Gear, sleeping bag, Coat, Hat gloves. PERMISSION SLIPS AND PAYMENT MUST BE SUBMITTED TO MRS. BARNARD OR MRS. PISCIOTTI BY THURSDAY, May 19, 2011 ================================================================================================================== Scoutmaster: Dick Barnard 973-597-0355
Committee Chairman: Bill Brady 973-740-1571 Cell Phone 973-879-8498 PERMISSION SLIP
(First and Last Name) 2. Permission is granted to Troop 12 leaders to authorize any emergency medical treatment required. 3. Parent contact in the event of an emergency: Phone Number: ___________________________ Alternate Phone Number: ______________________________
ADULT WILL BE ATTENDING:
Yes Name of adult attending: ________________________________________
ADULT NOT ATTENDING BUT CAN PROVIDE TRANSPORTATION:
Going
Departing: _______________________ with __________________________________ (Date / Time) (Person Providing Transportation) Returning: _______________________ with __________________________________ (Date / Time) (Person Providing Transportation)
PARENT’S OR LEGAL GUARDIAN’S SIGNATURE:____________________________________________________________________
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