TURRELL SUMMER CAMP
Dates: July 18-24th
Scoutmaster in Charge: Simon Fishman
Email: safishman@verizon.net
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Family Name: *
Email Address to communicate about this trip: *
Scouts Attending: *
Names of Scouts Attending: *
Adults Attending: *
Names of Adults' Attending: *
Cell phone numbers for those attending (if applicable): *
 Emergency Contact Person: *
Emergency Phone Number: *
 Do you have BSA Medical forms, parts A & B on file with Mrs. Burns? If no, please submit forms. *
In the space below, please list any important medical information we should be aware of (allergies, etc.) as well as any additional comments or notes. Enter "n/a" if none. *
  Please let us know about medications needed or specific medical concerns.  This include epi pens, inhalers, and topical or ingested medications.
Dietary restrictions *
Please list any dietary concerns. If dietary restrictions, please suggest several alternatives for the cooks.  Assume we won't know what you need - please e specific.  Thanks!
Required
Transportation:  Do you require a ride? *
Are you able to transport Scouts? How Many? *
Are any of you planning to arrive late/depart early? If so, when?
COOKING: * Do you wish to prepare meal(s) for this event? (limited cooking opportunities on-site) *
Is your meal prep required for advancement, and if so, which requirement? Do you require a Dutch Oven?
RELEASE: Please confirm the statement 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. *
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