Girl Scouts of Central Texas: Oak Hill Service Unit Troop 2041 Parent Permission Slip
RETURN THIS TO TROOP LEADER at [date, time]
My daughter ____________________________ has my permission to attend the Troop 2041 Winter Party on 12/20/13 to 12/21/13.
We will gather at 6:00 p.m. on 12/20 at the Elliott Barn. Please bring [insert list]. The girls will be picked up at 12 noon on 12/21.
My Scout will wear CLOTHES SUITABLE FOR hanging out. (The below section MUST be filled out each time.) IN CASE OF AN EMERGENCY PLEASE CONTACT:
| NAME___________________________________ | PHONE______________________ | OR_____________________ |
| NAME___________________________________ | PHONE______________________ | OR_____________________ |
| PHYSICIAN’S NAME___________________________ | PHONE__________________________________ |
| My insurance carrier:______________________________ | Policy #_____________________________________ |
PLEASE LIST SPECIAL NEEDS, MEDICATIONS AND COMMENTS BELOW:
- She is in good physical condition at present and has had no serious illness or operations since her last health examination.
- I will make sure that she does not attend if she is not feeling well.
- I give my consent for emergency care to be rendered by another licensed doctor, if unable to reach family doctor.
- If a private auto is to be used she has my permission to ride.
- I understand that volunteers and Girl Scouts of Central Texas cannot be responsible for loss of valuables.