Girl Scouts of
Troop
_1097 Date October 15, 2009___ Destination _Sup n sing
Address:
Arrangements for transportation
Time
and place of departure Meet @
Time
and place of return _Pickup- 8:30 pm at German Park____________
Type of
transportation __Car, van______________________________________
Leaders accompanying the girls
Name
Patricia Johnson_____ Cell#_496-3096_
Troop
pays 0 Girl
pays $ 5__Optional spending money _________________
Money
due to troop leader by (date)
___________________________________________________________
Each girl will need to
Dress for the weather: light
jacket, walking shoes
Other
equipment and clothing
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
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_________