Parental Permission Form

Troop is planning a

Date: Time

Location: Phone Number

Arrangements for transportation:

Time and place of departure

Time and place of return

Mode of transportation

Leaders accompanying the girls:

Name: Name:

Each girl will need:

Expenses:

Other equipment and clothing:

In case of an emergency, the leader will notify:
will immediately notify the parents.

Leader's Phone Number

My daughter has permission to participate in .

She is in good physical condition and has not had any serious illness or operation since her last health examination.

During the activity, I may be reached at:

Address

Phone Number

If I cannot be reached in the event of an emergency, the following person is authorized to act in my behalf:

Name and address

Relation to participant Phone Number

Physician’s name and phone number

Additional remarks: