Activity:	Fall Camporee (Pioneering)

Location:	Cadott (Hwy 27/Yellow River)

Dates:	Fri-Sun, Sept. 23-25, 2005

Meet at:	5:00 p.m. Friday, CVBC

Return:	11:45 a.m. Sunday, CVBC

COST: $16.00 (for food and $10 fee)

Emergency contact: Tom Arneberg's cell phone – 715-210-2684

Details: This will be our troop's first camporee in a while. A camporee is a fun event where scouts from several area troops gather together. The theme of this camporee is Pioneering, so there will probably be lots of lashing and building things with logs.

Retain the above information and return the form below with any money by Monday, Sept. 19, 2005. (If you can't make it to that meeting, MAIL IT IN to 1900 Eagle Street, Chippewa Falls, WI 54729 so that it arrives by that day.) We will be buying groceries that night during the meeting.

- - - - - - - - - - - - - - (cut here; return bottom portion) - - - - - - - - - - - - - - - - - - -

Activity:	Fall Camporee near Cadott

Dates:	Fri-Sun, May 27-29, 2005 (make checks payable to “Troop72.com”)

Fees:	$____ from boy's account + $____ enclosed check = $16.00

In consideration of the benefits to be derived, and in view of the fact that the Boy Scouts of America is an educational institution, membership in which is voluntary, and having full confidence that every precaution will be taken to ensure the safety and well-being of my Scout son/ward:

First_________________________________________ Middle____________ Last_________________________________________

on the activity above, I agree to his participation and waive all claims against the leaders of this trip, officers, agents and representatives of the Boy Scouts of America, and the sponsoring organization, Chippewa Valley Bible Church. In the event of an emergency, the troop leader of the activity named above has my permission to obtain medical treatment for this Scout at the nearest hospital or doctor, at my expense, if our own doctor is not readily available, and as restricted on the Emergency Data Sheet on file with the Troop.

( ) Yes, I will attend this activity with my son(s)

( ) Yes, I can drive ( to / from ) this activity; I can fit _______ scouts in my car

Signature of parent or guardian:_______________________________________________________ Date:__________________________

EMERGENCY INFORMATION: (In addition to Personal Health and Medical Records.)

During the activity listed above, I (parent/guardian) can be contacted at the following phone number(s):

(___________) ____________________________ (____________) ____________________________

This scout is highly sensitive to:

What, if any, medication is this Scout taking?

Any special instructions for this medication?

Do you want the activity leader to carry the medication?

(use back of this page for additional information or explanation)

Date of last tetanus shot/booster: _____________________	Date of birth:______________________

MEDICAL INSURANCE INFORMATION

Company:____________________________________________________________________________________

Policy Number: _________________________ Parent's SS#: ____________________________

Questions? Call Tom Arneberg or Darin Thomas, or see the www.troop72.com web page.

Thomas Arneberg

2001-06-30T19:57:21