| Permission Slips |
| Girl Scouts of River Bluffs Council Parent Permission Form Troop # 522 is attending the ___EASTER EGG HUNT______ on (date) Call Leader at (time) __2:00__ pm at (location) Call Leader Arrangements for transportation: Mode of transportation Parents will provide transportation Time and place of departure Parents will provide transportation Schedule to be followed ____________________________ Time and place of return Parents will provide transportation Leaders accompanying the girls: Name Chris S Name Pam R Each girl will need __A bag or bucket to collect eggs in___________ Expenses ___none_________ Other equipment and clothing comfortable and safe shoes In case of emergency, the leader will notify Emergency contact listed on Girls Information sheet and permission form Phone# listed below who will immediately notify the parents. Leader’s Signature Chris Scarbrough -------------------------------------------------------------------------------------------------------------------------------------- Tear off and return to troop leader by ________________ My daughter ___________________________ has permission to participate in ________________________ She is in good physical condition and has not had any serious illness or operations since her last health examination. During the activity, I may be reached at (phone #) _____________________________________, (address)________________________________________________________________________________. If I cannot be reached in the event of an emergency, the following person is authorized to act in my behalf: Name__________________________________________________ Phone #__________________________ Address_________________________________________ City________________________ Zip__________ Relationship to participant___________________________________________________________________ Physician’s Name____________________________________________ Phone #______________________ Additional remarks_________________________________________________________________________ If I am asked to be a driver for this event, I verify that I have a valid drivers license, my vehicle is properly registered, I have at least the state required amount of liability insurance (Illinois $20,000 bodily injury, $40,000 each accident and $15,000 property damage), and my vehicle is equipped with a first aid kit and other state required safety equipment and is in good working order. ______ Yes _______ No If no, please explain___________________________________ I have_____ have not ____ provided an appropriate child passenger restraint system for use in transporting my daughter who is under the age of 8. (Not applicable for girls age 8 and over.) Parent / Guardian Signature___________________________________________ Date__________________ GSRBC 3/2/05 word / f:/ forms / parent permission form |
| Directions Copy Permission Slip, Click on Email Permission Slip, Paste form into email page, Fill in the neccessary information, and Send. |