TROOP 376

                                         TRIP PERMISSION SLIP

           I _____________________________ parent/guardian of scout

            _________________________ give permission for my son to participate

            in the following activity _____________________________________.

            I understand that my son with be departing from Our Lady of Grace Church

            Ave W & E4th Street Brooklyn, NY on ___________________________

            at 7:00pm & will be returning on ________________________  between

            1:30pm - 4:00PM

             Print Name        ________________________

             Parent Signature ________________________

             Date                  ________________________

             Parents/Guardians are to understand that there may be a time when the Unit

             may be short on cars and will be called upon to provide transportation for

             some scouts to and from one of the trips.

             I  (will / will not) be able to provide transportation on this trip

              EMERGENCY CONTACT INFORMATION

                 Home Phone #__________________________

                 Cell Phone    #__________________________

     Other family member #__________________________