Boy Scout Troop 360

Faith Lutheran Church

Marion, Iowa 52302

Required Permission Form to participate in Troop 360 BSA related activities

Scout Name:                                                                                                                                       

I/We, the parent/guardian(s) of the above-named youth, do hereby permit him to participate in Boy Scout sponsored activities during the period                                                      .  We understand that Boy Scout events may involve strenuous outdoor activities.  We recognize that there are risks involved in any activity.  We agree to hold blameless Troop 360, its sponsor – the Faith Lutheran Church, the Boy Scouts of America, and the volunteers assisting with the activities from any liability or claim which may arise due to injury to the Scout named above.

The undersigned understands that the Troop carries limited medical coverage for any registered Boy Scout of Troop 360 who is injured during a scout activity.  The undersigned also appoints the Scoutmaster, or an Assistant Scoutmaster of Troop 360, or an adult volunteer assisting in the activity to authorize any reasonable medical treatment or procedure on behalf of the youth named above without further consultation with me (us).  If there are any limitations to this authorization, I shall write them on the back of the sheet.

Parent/guardian signature                                                                                                                                                 

Date                                                                                                                                                                                      

Address                                                                                                                                                                                 

Phone Numbers:  Home                                       Cell                                          Work                                                  

Troop Copy

                                                                                                  cut                                                                                                       

Boy Scout Troop 360

Faith Lutheran Church

Marion, Iowa 52302

Required Permission Form to participate in Troop 360 BSA related activities

Scout Name:                                                                                                                                       

I/We, the parent/guardian(s) of the above-named youth, do hereby permit him to participate in Boy Scout sponsored activities during the period                                                      .  We understand that Boy Scout events may involve strenuous outdoor activities.  We recognize that there are risks involved in any activity.  We agree to hold blameless Troop 360, its sponsor – the Faith Lutheran Church, the Boy Scouts of America, and the volunteers assisting with the activities from any liability or claim which may arise due to injury to the Scout named above.

The undersigned understands that the Troop carries limited medical coverage for any registered Boy Scout of Troop 360 who is injured during a scout activity.  The undersigned also appoints the Scoutmaster, or an Assistant Scoutmaster of Troop 360, or an adult volunteer assisting in the activity to authorize any reasonable medical treatment or procedure on behalf of the youth named above without further consultation with me (us).  If there are any limitations to this authorization, I shall write them on the back of the sheet.

Parent/guardian signature                                                                                                                                                 

Date                                                                                                                                                                                      

Address                                                                                                                                                                                 

Phone Numbers:  Home                                       Cell                                          Work                                                  

Parent’s Copy