BOY SCOUTS OF AMERICA
TROOP 966
I approve of participating in the outing described below:
Outing: ROCK CLIMBING — JOSHUA TREE NATIONAL PARK
Time/Date Leave: 4:00 PM (or as arranged), FRIDAY, FEBRUARY 25, 2011
Time/Date Return: 5:00 PM, SUNDAY, FEBRUARY 27, 2011
Assemble At: EL RETIRO PARKING LOT
I understand that my son will be under the supervision of the Scoutmaster or his authorized representative. I
give my permission to the officers, leaders, and agents of the Boy Scouts of America, Los Angeles Area
Council, to obtain and administer such medical aid or assistance as might be required for the care of our boy in
the event such help becomes necessary. It is further understood such permission will include the administration
of medicines or treatment as might be ordered or administered by a duly licensed physician.
In no event shall the Boy Scouts of America, the Los Angeles Area Council, its officers, leaders, or agents be
held liable for any aid rendered, treatments, drugs and medicines, or surgical procedures performed pursuant to
this consent with the understanding that the troop is covered by the regular Boy Scouts' insurance.
PARENT SIGNATURE
Camp Fee: $4.00
ADDRESS Food & Supplies: 15.00
Transportation: 14.00
PHONE NUMBER (310) TOTAL (per person): $33.00
PARENT PLEASE CIRCLE:
I will will not be able to stay overnight: Name(s)
I will will not be able to help with transportation.
Return this form with payment by Monday, February 21. (Make check payable to Boy Scout Troop 966.)
PARENTS PLEASE SIGN AND DATE HOLD HARMLESS AGREEMENT (SEE OTHER SIDE)
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PARENT’S COPY (TEAR OFF)
Outing: ROCK CLIMBING — JOSHUA TREE NATIONAL PARK
Time/Date Leave: 4:00 PM (or as arranged*), FRIDAY, FEBRUARY 25, 2011
Time/Date Return: 5:00 PM, SUNDAY, FEBRUARY 27, 2011
Assemble At: EL RETIRO PARKING LOT
PLANNED ACTIVITIES: Rock climbing, rappelling and bouldering will be the main theme for the weekend. If you
want to improve your climbing skills, you don’t want to miss this outing! In addition, Mr. Schwitkis and Mr. Johnson
may set up an orienteering course so that you can test your map and compass skills by zipping around searching
for control points. And if climbing and orienteering aren’t on your list of favorite things, come out anyway and just
enjoy a great weekend in the desert; there is no shortage of interesting things to do. For example, there are seven
peaks on LAAC’s Mini-Peak Bagger list in Joshua Tree NP. We can go bag one or two of those. Or if you want to
work on rank advancement, this is the place for that too. The night sky at Joshua Tree has actual stars, including
the North Star, so you can finally get signed off on First Class Requirement 1. Bring your Scout Handbook.
1. Full uniform (Scout shirt and pants) must be worn to & from outing.
2. Bring leather gloves for rappelling and don’t forget your compass (for orienteering course).
3. Bring your own eating utensils and put your name on them.
4. Bring $15.00 to cover for dinner on Friday evening and lunch on Sunday.
PARENTAL INFORMED CONSENT AND HOLD-HARMLESS
AGREEMENT FOR CLIMBING/RAPPELLING ACTIVITY
I understand that participation in climbing/rappelling activities involves a certain degree of
risk that could result in injury or death. In consideration of the benefits to be derived and
having full confidence that precautions will be taken to ensure the safety and well-being
of my son, and after carefully considering the risks involved, I hereby
give my consent for my son, (Name) ,
to participate in the climbing/rappelling activity offered through Boy Scout Troop 966, Los
Angeles Area Council, Boy Scouts of America, at Joshua Tree National Park on February
25-27, 2011.
In addition, I hereby release and hold harmless, and waive all claims that I might have
against the Boy Scouts of America, Los Angeles Area Council, activity coordinator(s), all
employees, volunteers, or other organizations associated with the Joshua Tree activity.
In case of emergency, I understand that every effort will be made to contact me. In the
event I cannot be reached, I hereby give my permission to the physician selected by the
adult leader in charge to secure proper treatment, including hospitalization, anesthesia,
surgery or injections of medication for my child.
(This form should have the signatures of both parents/guardians, if possible)
Signature Signature
Date Date