Troop 105, Travel/Event Participation Permission Form and Driver Info Form

From: David Skolnick
To: Troop 105 Parents and Scouts; Visiting Webelos, Den Leaders, and Parents
Cc: Mike O'Melia
Subject: Troop 105, November 2008 , Campout Info and Permission Slip

Greetings Parents and Scouts,

For the November 2008 campout, Troop 105 will camp overnight at Cranberry Watershed Preserve (Kingston, MA), hike the Bay Circuit Trail through Kingston and Pembroke, and camp overnight at the Pembroke Town Forest (Pembroke, MA) program.

Campout Information:

RESPONSE REQUIRED: Completed Permission Slips for scouts, leaders, Webelos, and parents are due back by Monday, November 10, 2008 (at Troop meeting). Please give your forms to our Camping Coordinator, Doug Lyons (or designee).

WHAT: Trip to Cranberry Watershed Preserve, Bay Circuit Trail, and Pembroke Town Forest to enjoy a hiking and camping program; tents, suitable hiking shoes, warm cloths/sleeping gear required

WHEN: (Scouts) Friday, November 21, 2008 (~7pm) to Sunday, November 23, 2008 (~10am)

(Webelos) Saturday, November 22, 2008; meet at water tower adjacent to Silver Lake High School at 9am to depart on hike; if you miss the departure, you can meet up with the group at 11am at Tubb's Meadow Preserve.

It is recommended that Webelos carry only water and a sack lunch on the hike. Webelos leaders are encouraged to leave their Den's gear parked at the Silver Lake High School parking lot for the hike. After the hike, Troop 105 will shuttle Den leaders back to the high school to transport the Webelos gear to the baseball field parking lot (off Mattakeeset St., Pembroke).

Webelos are welcome remain after campfire for sleepover on Saturday night and breakfast Sunday morning (provided by the Troop), but must be accompanied by a parent/guardian for the sleepover and provide their own tent.

WHERE: Cranberry Watershed Preserve (Kingston, MA) and Pembroke Town Forest (Pembroke, MA)

TIMES: Meet at Cranberry Watershed Preserve (park in Silver Lake High School parking lot, next to water tower) in Kingston (Scouts Friday night, Webelos Saturday morning). Check in with Mr. Skolnick on arrival. Pickup scouts and Webelos from Pembroke Town Forest (baseball field parking lot off of Mattakeesett St.) in Pembroke on Saturday night ~10pm (Webelos) or Sunday morning ~10am (scouts and Webelos). Check out with Mr. Skolnick before leaving.

ACTIVITIES: The camp out activities will include a hike, camp out, and service project (in planning) program

MEALS: Patrols (including the combined Senior patrol and Adult leaders) will plan their meals for this weekend. Scouts/Leaders must bring their own mess kits. The Troop will provide a common wash station for cleanup. Webelos staying for meals will be assigned (likely on a Den basis) to eat with a patrol.

COST: $12 per scout ($6 per Webelos), person includes campsite and food, payable when submitting the permission form. Patrol leaders will be reimbursed $12 per person eating with their patrol. Budget food purchase accordingly. (A scout is thrifty.)

Webelos, note that the typical price for campsite/food $12 per person. Because the Webelos will be present for 1/2 of the meals, their price is 1/2. The troop subsidizes its camping program through fundraising to keep this campout price stable.

CONTACT INFORMATION DURING EVENT: David Skolnick, cell phone, 781-856-5884

CONTINGENCIES: In case of severe weather, the troop and Webelos will use the Grange hall on Route 27 (32 School St., Pembroke) for the sleep over. If this contingency is applied, all parents will be notified of the change to pick-up location for Sunday morning.

Permission Slip:

Scout/Adult Name Age

Address

Participant Itinerary Information:

Unless otherwise noted below, it is assumed that all scouts and adults will be:

Departing from Pembroke with the troop,
Eating all meals with the troop,
Participating in all planned activities, and
Returning to Pembroke with the troop.

Personal (Exceptions To Group) Travel Itinerary:
Late Arrivals Arrival Date Estimated Arrival Time

Early Departures Departure Date Estimated Departure Time

Other

**Personal (Exceptions To Group) Travel Itinerary:**
Late Arrivals Arrival Date		Estimated Arrival Time
Early Departures Departure Date		Estimated Departure Time
Other

Note: Any changes to Scout(s) personal travel itinerary, unless documented on this permission slip for this event, must be communicated to the Camping Coordinator, Committee Chairman, or Scoutmaster.

In case of emergency, notify:
Name: Relationship: Parent/Guardian

Address:

Home Phone: Cell Phone:
Other Instructions:

Med. Ins. Plan: Policy #:

**In case of emergency, notify:**
Name:	Relationship:	Parent/Guardian
Address:
Home Phone:	Cell Phone:
Other Instructions:
Med. Ins. Plan:	Policy #:

Have or is subject to (check if yes):
Asthma Fainting Convulsions Diabetes Heart Cond.

Allergies List:

Medication Reactions List:

Condition/Medication(s) List:

Activity Restrictions Describe:

**Have or is subject to (check if yes):**
Asthma	Fainting	Convulsions	Diabetes	Heart Cond.
Allergies	List:
Medication Reactions	List:
Condition/Medication(s)	List:
Activity Restrictions	Describe:

For adults/leaders, indicate most recent training date for BSA Youth Protection Training. ____/____/________

Parent authorization to be signed by parent of those under 18 years of age:

I give my son permission to participate in the planned trip to Cranberry Watershed Preserve (Kingston, MA) and Pembroke Town Forest (Pembroke, MA) to camp and hike along the Bay Circuit Trail from Friday, November 21, 2008 to Sunday, November 23, 2008. The person herein described has my permission to engage in all prescribed activities except as noted by the physician and me. In the event I cannot be reached in an emergency, I hereby give permission to the physician selected by the adult leader in charge to hospitalize, secure proper anesthesia, or to order injection or surgery for my son.

Name (print) Relationship (circle one): Parent/Guardian

Signature Date

Driver Info Slip:

(Drivers need to complete both the driver info slip and provide their information on the permission slip.)

I, ________________________________________ (Adult/Leader) will be able to drive ______ (number of scouts) either (circle one) To or From or To-and-From this event.

BSA Tour Permit Info
Driver's License Number State

Vehicle Make and Model Year

Vehicle Registration No. State

Passenger Capacity

Liability Ins. Amount/Accident Liability Ins. Amount/Passenger

**BSA Tour Permit Info**
Driver's License Number		State
Vehicle Make and Model		Year
Vehicle Registration No.		State
Passenger Capacity
Liability Ins. Amount/Accident		Liability Ins. Amount/Passenger

Driver's Pledge
I will follow the BSA guidelines for safe driving, and I will make sure that all occupants of my vehicle wear seat belts at all times while in my vehicle.
Name (print) Vehicle (circle one): Owner/Leasee

Signature Date

Name (print)		Relationship (circle one):	Parent/Guardian
Signature		Date