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BSA Troop 677 Activity Permission Form Outing *** Parent or Legal Guardian Signature Required *** Zipline/Onondaga Cave State Park – November 8-10, 2013 Due Date: October 22, 2013 Troop Meeting Refund Date: October 29, 2013 Please Print Information My son(s) / ward(s) ______________________________________________________________________ has permission to attend the Zipline/Onondaga Cave State Park Outing on the dates of November 8-10, 2013, at Onondaga State Park. He is in good physical condition and I will make sure that he does not attend if he is not feeling well. He may receive emergency treatment at my expense. Signature of Parent or Legal Guardian _______________________________________________ Phone # (_____) _____-_________ Date ______/_____/______ Emergency Information Name Phone Number Insurance Company Name Policy Number Comments concerning my son(s)/ward(s) health, medications, or special needs: _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ Adults are always welcome to attend Scouting events. I am able to attend and would like to assist in the activities or other responsibilities. Adult(s) Attending: ______________________________________________________________________________________ Transportation: My son(s)/ward(s) have a ride to/from the outing with ____________________. If driving, please provide year/make/model of vehicle _______________________, number of seatbelts _________, and insurance carrier name/coverage (i.e. State Farm, 100/300/100) _________________________________________________ Activity Fee: $50:00 per Scout *Please make checks payable to “BSA Troop 677” $25.00 per Adult Due Date: October 22, 2013 Refund Date: October 29, 2013 The permission slip and check may be given to Quinn Graessle at troop meetings or mailed to: Quinn Graessle 232 Old Ballwin Rd. Ballwin, MO 63021 (636) 527-1921 (H) (636) 675-6614 (Cell) _______________________________________________________________________________________ Detach and retain for your information Zipline/Onondaga Cave State Park Outing OBJECTIVE: A great experience where you can zipline, hang out on a river bank and camp out. DATE: Nov. 8-10, 2013 REFUND DATE: Oct. 29, 2013 LOCATION: Onondaga Cave State Park, Leasburg, MO – Blue Springs Ranch in Bourbon, MO for Zipline DEPART: Arrive Friday @ 5:45pm at Living Word Church parking lot. Departure @ 6:00pm sharp; Drive time approx. 75 minutes. Bring money for dinner on the way. RETURN: Sunday, 10:00am @ Living Word Church parking lot. MAP: Maps will be provided at departure TRANSPORTATION: Coordinated by patrols COST/FEES: $50.00 per Scout, $25.00 per Adult which includes: Camping fees for 2 nights; Saturday breakfast, lunch, dinner, Sunday breakfast and two Cracker Barrels (Friday and Saturday) and the Blue Springs Ranch Zipline. MEALS: By patrol method ITEMS TO BRING: A great attitude along with: Class A Uniform (wear Friday and Sunday while traveling) Pocketknife (if you have a Tot’n Chip) & Toasted Chit $$ for Friday dinner on way to Leasburg Clothes for variable weather Boy Scout Handbook, Notebook (or paper) and Pencil (or pen) Rain Gear Sleeping bag and pillow Stool for campsite Compass Hiking Boots Flashlight Toothbrush, Toothpaste, Soap, Hand Towel Water bottle, Mess Kit and Cup Sun Screen and Non-Aerosol Insect Repellent LEAVE HOME: Electronic games, Portable CD players, TVs, Radios
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