Activity:	Indoor Amusement Park

Location:	Mall of America

Dates:	Wednesday, Feb. 25, 2009

Departure:	8:00 a.m., CVBC

Est. Return:	5:00 p.m., CVBC

COST: $20.00 ( $16 for tickets, $4 gas)

(FOOD IS ON YOUR OWN!)

Emergency contact: Mike Wells's cell phone: 715-563-5119

Details: The Patrol Leaders Council of Troop 72 wants to return to the Mall of America for the third year. This year they are targeting the middle of the winter break. The mall will give discounts to non-profit groups who reserve in advance (and pay with one check or credit card), so we can get all-you-can-ride wristbands good for five hours for only $16 each. Scouts should bring spending money for any food needed during the day. NOTE: Boys must always be with at least one buddy, but there will NOT be constant adult supervision, as small groups of boys will be headed in different directions all the time. If you're unsure whether your son can accept this level of responsibility, you may want to pass on this trip.

Retain the above information and return the form below with any money as soon as you can. Reservations in the church van will be first-come, first-served. If we have a second driver, we may take a second van if it's available. (In any case, we are required to have two adults over 18, and a driver of the church van must be over 25 and have a good driving record.)

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Amusement park at Mall of America (Bloomington, MN)

Dates:	Wednesday, Feb. 25, 2009

Fees: $______ from boy's account + $______ enclosed check = $20.00

(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