Trip Permission Slip

 

                       Parker County Young Marines

                                 Permission Slip

 

My Young Marine _________________________________ has my permission to go on the Still Waters Retreat, Springtown, Texas trip with the Parker County Young Marines for an Overnight Encampment on August 25th & 26th, 2018.

 

I will not hold the staff, headquarters, or any part of the Young Marines liable for accidents that could occur.  In the event that an accident should occur, please transport my child to (hospital/doctor) ___________________________________

 

My Young Marine will conduct himself/herself in such a manner that represents the Parker County Young Marines.  He/she will dress appropriately, and respond accordingly.

 

My Young Marine does ____ or does not ____ have allergies.

Please list allergies: __________________________________________________

 

My Young Marine will ____ or will not ____ be on medication at the time of the above mentioned trip/excursion/encampment.

 

Please list any Medications: __________________________________________________________

 

Dosage: ___________________________________________________

 

Times to be given: ___________________________________________

 

Parent Contact Information

 

Name: ____________________________________________________________

 

Address: __________________________________________________________

 

City: __________________________________, Texas, Zip: ________

 

Phone (H): _______________________ (C): _______________________

 

Parent/Guardian Signature: ___________________________________________________________

 

Dated this _____________ day of __________________________, 2018

 


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