4:00 PM - 10:00 PM Thursday March 24, 2005 (Permission slips due by Thursday March 17,2005)
On March 1, 1997 the Boy Scouts of America formally recognized "Climbing" as a fun and worthwhile activity by creating the "Climbing" Merit Badge. We are continuing this program. On Thursday March 24, 2005 Troop 10 will be going rock climbing again to the "Mill City Rock Gym" in Dracut MA. Past rock climbing trips have been very well received by the boys and their parents. This is a great opportunity to have the boys safely introduced to the sport of rock climbing.
_________________________________ cut here ______________________________
As the parent or legal guardian of _________________________, I hereby give my permission for this child to participate in an outing with Troop 10. A current Med. Form must be signed with in the last 2 years initialed within 1 year Includes any event that does not exceed 72 consecutive hours, where the level of activity is similar to that normally expended at home or at school, and where medical care is readily available. Examples: day camp, day hike, swimming party, or an overnight camp. Medical information required is a current health history signed by parents or guardian.
Class 3: Includes any event involving strenuous activity such as backpacking, high altitude, extreme weather conditions, cold water, exposure, fatigue, athletic competition, adventure challenge, or remote conditions where readily available medical care cannot be assured Medical information required includes current health history supported by a medical evaluation
Location: Mill City Rock Gym, Dracut Mass Activity: Rock Climbing
Departure Time: 4PM Date: 3/24/05 Return Time: 11PM Date: 3/24/05
I give permission to the leaders of the above unit to render First Aid, should the need arise. In the event of an emergency, I also give permission to the physician, selected by the adult leader in charge, to hospitalize, secure proper anesthesia, order injection, or secure other medical treatment, as needed. I further agree to hold the above named unit and its leaders blameless for any accidents that might occur during this outing except for clear acts of negligence or non-adherence to BSA policies and guidelines.
I can drive _____ TO FROM I can chaperone _____
Vehicle Make_______ Model_________ Year____ Reg. # ___________ # of Seatbelts__________
In case of emergency, I can be reached by phone at ____________________ or ____________________.
If I cannot be reached, please contact _________________________ at ____________________.