Activity:	RIPLEY RENDEZVOUS!

Location:	Camp Ripley (near Brainerd, MN)

Dates:	June 1-3, 2007

Departure:	4:00 p.m. (?) Friday, CVBC

Est. Return:	2-4pm (?) Sunday, CVBC

COST: $45.00 ($38 for registration; $7 for gas, snacks(?))

Emergency contact: Tom Arneberg's cell phone: 715-529-1536

Details: Okay, here is a once-in-a-lifetime (or maybe twice) experience – spending a weekend with 10,000 Scouts from all over the midwest! Normally this only happens at the National Jamboree in Washington, DC., but now there's a mini-jamboree every four or five years about 220 miles from Chippewa Falls. None of us have ever done this before, but we're going to try it out and see what it's all about. Please note they have a registration deadline of April 13 – and there's no meeting on Monday, April 9, due to the school holiday. So you 'll have to drive it or snail-mail it to my house be then!

Retain the above information and return the form below with any money by 5:00 p.m. FRIDAY, APRIL 13, 2007

If you want more info on the Ripley Renezvous, please read the links on our web page, www.troop72.com.

Date of Birth______________________________

Program (choose ONE): __ Action Center (any age) __ Adventure (13+) __ X-TREME (15+)

Do you want to participate in a Merit Badge Workshop? __ YES __ NO

"RIPLEY RENDEZVOUS"

Dates:	June 1-3, 2007

Fees: $______ from boy's account + $______ enclosed cash/check = $45.00

(make checks payable to "Troop72.com")

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, namely:

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 (726-4074) or see the www.troop72.com web page.

Thomas Arneberg

2005-02-21T19:49:00