Boy Scout Troop 212
Chapel Hill Presbyterian Church
Troop Outing Permission Slip

I, the parent or guardian of _____________________________________________________
hereby give my consent and permission to participate in the:

__SUBASE BANGOR / SUBMARINE TOUR___ Outing

From (Departure Date)__May 11, 2007__To (Return Date)__May 11, 2007__

I do hereby waive, release, absolve, indemnify, and agree to hold harmless any person connected with Chapel Hill Presbyterian Church, Troop212, the scouting program, and persons transporting my child

I am willing to provide transportation  ________  Number of people including driver _______

My son will be arriving late / leaving early ________  If yes, please provide details below

_____________________________________________________________________________

My son has a medical condition (i.e. allergies, etc.) and / or is taking medication __________
If yes, please provide details below.  Please contact the adult in charge with written Instructions.

 _____________________________________________________________________________

_____________________________________________________________________________

Must be a US citizen, 11years old or older, and have a picture I.D on the outing.

Require last four digits of scouts social security number ______________ 

Emergency contact if you are unavailable

Name_____________________________________________

Phone ____________________________________________

Signed_____________________________________Phone_______________Date___________

_____________________________________________________________________________
detach here

Retain this portion until the outing is complete

Outing Name __SUBASE BANGOR / SUBMARINE TOUR__

Meet at QM Container____8:00 am  Friday May 11___________________

Return to QM Container __ 4:00  pm Friday May 11__________________

Adult in charge __Mr. Ollice______________ Phone__360-476-1646______

Emergency contact:  Gretchen McKinney            Phone    235-549-2959

Cost $3.00

Scouts: Wear your scout shirt during the outing.  Must have a picture I.D to get on the Subase.  Lunch will be furnished.