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:

__OMSI OUTING - PORTLAND___ 

COST - $55.00

From (Departure Date) _December 15, 2007__To (Return Date)__December 16, 2007__

I do hereby waive, release, absolve, indemnify, and agree to hold harmless any person connected with Chapel Hill Presbyterian Church, Troop212, and 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.

 _____________________________________________________________________________

_____________________________________________________________________________

Emergency contact if you are unavailable

Name_____________________________________________

Phone ____________________________________________

Signed_____________________________________Phone_______________Date___________

_____________________________________________________________________________
detach here

Retain this portion until the outing is complete

Outing Name __OMSI OUTING - PORTLAND____________

Meet at QM Container____9:00 am  Saturday, December 15___________________

Return to QM Container __ 3:30  pm Sunday, December 16 __________________

Adult in charge __Cliff Uehlin______________ Phone__253-265-8345______

Emergency contact:  Gretchen McKinney            Phone    235-549-2959

COST - $55.00

This outing is an overnight on a submarine and visit to the science center/planetarium at OMSI in Portland, Oregon.
Scouts: Wear your scout shirt during travel.   Bring a sack lunch for Saturday.  You need a daypack and ten essentials and supplies for the sub sleep over.