Girl Scouts Diamonds Of Arkansas, Oklahoma, And Texas Parental Permission Form printable pdf download

Girl Scouts Diamonds of Arkansas, Oklahoma, and Texas

Parental Permission Form

Troop/Group #__________is planning ____________________________________________________________________

(trip or attending an event)

on____________________at____________________________________________________________________________

(location)

Arrangements for transportation:

Time and place of departure_____________________________________________________________________________

Time and place of return________________________________________________________________________________

Mode of transportation_________________________________________________________________________________

Leader/Advisors accompanying the girls:

Name_______________________________________________________Phone_________________Cell_______________

Each girl will need: For expenses_________________________________________________________________________

Other equipment or clothing:

_____________________________________________________________________________________________

In case of an emergency or delay, the leader/advisor will notify the troop/group contact person at home who will

immediately notify parents. The contact person is:

Name_______________________________________________________Phone_________________Cell________

Address_______________________________________________________________________________________

Leader/Advisor signature________________________________________________________________________

………………………………………………………………………………………………………………

CUT OFF AND RETURN TO LEADER/ADVISOR)

(

My daughter,______________________has permission to participate in the above named activity. In case of

accident or injury she may be given emergency first aid treatment.

I authorize the person in charge or______________________________________________________to act in my

behalf.

During the activity I may be reached at this number:______________________________________

If I (we) cannot be reached in the event of an emergency, the following person should be contacted:

Name_____________________________________________________Phone_________________Cell__________

Address______________________________________City________________________________________State_

Relationship to participant________________________________________________________________________

My daughter is in good physical condition at present and has had no serious illness or operation since her last health

examination. I will ensure that she does not attend if she is not physically able. I will ensure that she has the

required equipment, clothing and supplies with her.

She will have medication with her. It will be in the original bottle, in a plastic baggie and labeled for the First Aider.

Her medication(s) are as follows::

_____________________________________________________________________________________________

Parent/Guardian signature___________________________________________________Date________________

Girl Scouts Diamonds Of Arkansas, Oklahoma, And Texas Parental Permission Form