________________________________ on (dates)

______________________, and the adult leaders of Troop 681 have my permission to sign any waiver of liability which may be required. In the case of injury or illness, the leaders of Troop 681 are authorized to render emergency first aid and/or seek all necessary medical attention. In such cases, I understand that I will be notified as soon as possible. I agree to hold harmless and blameless, the leadership of Troop 681 (including members of Troop 681's committee and any additional adults participating in or providing assistance to the activity) from any injury or illness resulting from participation in this activity. I waive all rights to any civil action against the above mentioned parties. I have noted any medical or other special consideration on the Troop 681 Emergency Medical Treatment Form; if my son has had any serious illness, injury, or medical treatment over approximately the last 6 weeks of which the Troop should be aware, I have provided the details on the upper half of the back of this permission slip (check here if applicable: ________). I understand that a medical clearance or doctor's note may be required prior to participation.

Finally, I understand that my signature verifies that I am aware of and in agreement with any restrictions or cautions listed on the actual permission slip for this event, and that this generalized, electronic copy is merely a replacement of convenience.

____________________________________

(Printed Name of Parent or Guardian)

____________________________ ____________ (Signature of Parent or Guardian) (Date)

2. If you will not be at home or work during this event, please list an emergency telephone number where you can be reached (and the contact person at that number)

___________________________________

3. Please remember that the Troop needs/expects parents to attend and/or drive for at least one of every three events their sons attend to provide adequate transportation and supervision. Please fill in one of the following:

________________________ will attend this event;

________________________ will drive for this event;

________________________ cannot attend or drive

4. Payment Option (please check one):

CASH _______ CHECK _______ TROOP CREDIT _____ (only if positive balance!)

- Please sign and return ASAP -

NOTE: Details on each trip are found in the formal permission slips. We will try to keep the Website current with respect to all upcoming activities. This generalized permission slip is available for you to fill out if you have misplaced the original.