Day Tour of West Point, NY on April 10, 2010

* 1. Scouts Last Name:

* 2. Parent/Guardian First and Last Name:

* 3. Emergency Contact Name (Who should we call if there is a problem on the trip?):

* 4. Emergency Contact Phone Number (What number should we call if there is a problem on the trip?)

* 5. Parent E-Mail Address:

* 6. Number of participants from your family:

7. Cell phone number:

8. In the space below, please list each participants name, age - under/over 16, and type of ID they will be using for the visit. You may also add any additional comments or notes:

*15. Please confirm the following by selecting the corresponding radio button below:
In consideration of the benefits to be derived, and in view of the fact that the Boy Scouts of America is an educational institution, membership in which is voluntary, and having full confidence that every precaution will be taken to ensure the safety and well being of my Scout son/ward on the activity named, I agree to his participation and waive all claims against the leaders of the activity, officers, agents and representatives of the Boy Scouts of America. In the event of an emergency, an adult leader of this activity has my permission to obtain medical treatment for this Scout at the nearest hospital or doctor, at my expense, if our doctor is not readily available.
Agree
Disagree