Girl
Scouts of
Troop _1097 Date November 21,
2009___ Destination _I.U. math and Science Day @ I.U. Bloomington
Arrangements
for transportation
Time and place of departure Meet @
:Time
and place of return _Pickup- 5:30 pm at Pleasant Grove parking lot
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 I.U. math and
Science Day
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_________