Girl
Scouts of
Troop _1097 Date Saturday March 20,
2010___ Destination Brownie Badge Event /Sleepover at The Benedict Inn
Retreat and
1402 E. Southern Ave Beech Grove, IN phone:
788-7581
Arrangements
for transportation
Time and place of departure: meet at the
Time and place of pickup: at the
Type of transportation each girl will
arrange own drop off and pickup__
Leaders accompanying the girls
Name Patricia Johnson_____ Cell#_496-3096_
Troop pays: Girl pays:$10
________________
Money
due to troop leader by (date) March 4th
Each girl will work on several badges
with a Cadette troop, swimming pool, snack, breakfast in am,
In case of an emergency
Leader
will notify the troop emergency contact person who will immediately notify the
parents.
Emergency contact person _Jeff Johnson_____
Phone __889-9275_______
Leader’s
signature Patricia Johnson________________________
Tear off bottom half and return
to troop leader by (date) _______
---------------------------------------------------------------------------------------------------------------------
My
daughter ______________________ has permission to attend the Girl Scout trip to
the
Participate
in the described activity, I may be reached at (phone)
(________) _______________________________________
If
I cannot be reached in the event of an emergency the following person is
authorized to act on my
behalf:
Name _________________________________ Phone (___) ____________
Relation
to participant ______________________________________________________________________Address
_____________________________________________City __________________ZIP
_____________Additional remarks: Please note if your child has any specific
limitations and/or special needs, including medications. Use additional sheet
if necessary
Parent’s Signature
_________________________________Date_________