2006 - STANDARD ANNUAL PERMISSION FORM AND WAIVER OF LIABILITY

By signing my/our name(s) to this form, I/we give permission for my/our son, grandson, stepson, or ward, ________________ _________________________________, to attend all Troop #1 activities and events as scheduled on the Troop 1 - 2006 Calendar, starting in February 1, 2006 and running through January 31, 2007, and any other scheduled or unscheduled Troop #1 activities, events, outings or meetings during 2006 and January of 2007.

I/we fully realize that participation in Troop 1 activities includes private and/or commercial transportation to and from the outings or events, and may include strenuous activities and/or activities that may be potentially hazardous, including but not limited to the following activities and environmental conditions: five-mile or greater hikes with heavy backpacks, wading across creeks and streams, night hikes, sleeping outdoors in tents and out of tents, building and lighting fires, cooking over a campfire or camp stove, using various camp tools (axe, hammer, saw, knife), lighting, filling and using liquid fuel and propane lanterns and stoves that contain combustible and explosive fuel, flat water and whitewater and boating activities (swimming, water skiing, motor boating, sailing, rowing, rafting, canoeing, kayaking), rifle and shotgun shooting, using bows and arrows, rock climbing and repelling, cave exploring and sleeping in caves, snow sports (skiing, snowboarding), ice skating, competitive games, horseback riding, bicycle riding, cold and hot weather, sub-freezing temperatures, rain, wind, hail and snow, purifying and drinking water from lakes, creeks, springs and ponds, paintball games, high and low ropes-type challenge courses, and community service work projects. I/we fully understand that the activities listed above are a partial list of the activities that may be involved. I/we also realize that the activities planned for any particular outing may be changed before or during the outing and that other potentially strenuous and/or hazardous activities may be substituted for the planned activities.

Further, by signing my/our name(s) to this form I/we waive all rights of liability against the adult and youth leaders and members of BSA Troop #1, The Boy Scouts of America and its representatives, the Shawnee Trails Council, Four Rivers District BSA and its representatives, and Grace Episcopal Church of Paducah and its representatives. Further, I/we waive all rights of claim in the event of the accidental death, drowning, disfigurement or dismemberment of my/our above-named son, grandson, stepson or ward at any Troop, Council or District activity, meeting, event, campout, or cleanup.

My/our signature(s) here attached also certifies that my/our above-named son is physically, mentally, and biologically able to participate in the activities listed above and in the transportation to and from the listed activities. In the event that I/we do sign this form while knowing that my/our son is not physically, mentally, or biologically fit to participate in these activities, I/we will be fully responsible for any and all costs incurred by myself/ourselves, my/our family, Troop #1 and its adult and youth leaders and members, the BSA, and Grace Episcopal Church. Also, in the event of an emergency, I/we give my/our permission for adult and youth leaders and members to render and/or obtain emergency medical treatment for my/our son, to submit my/our insurance information, and I/we promise to be responsible for all expenses incurred for and during the said emergency medical treatment.

MUST BE SIGNED BY BOTH CUSTODIAL PARENTS/GUARDIANS AND BY THE SCOUT. IN SINGLE PARENT FAMILIES, CUSTODIAL PARENT MUST SIGN AND INDICATE THAT NO OTHER PERSON HAS ANY RIGHTS OR CLAIMS ON THE ABOVE NOTED CHILD.

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(Parent’s or guardian’s signature) (date)

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(Parent’s or guardian’s signature) (date)

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(Scout’s signature) (date)

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(Parents’ or Guardians’ Insurance Co.) (Policy Number / Group)