I give permission to the leaders of the above unit to render First Aid,should the need arise. In the event of an emergency, I also give permission to the physician, selected by the adult leader in charge, to hospitalize, secure proper anesthesia, order injection, or secure other medical treatment, as needed. I further agree to hold the above named unit and its leaders blameless for any accidents that might occur during this outing except for clear acts of negligence or non-adherence to BSA policies and guidelines.
In case of emergency, I can be reached by phone at ________________ or ________________. If I cannot be reached, please contact ____________________________________ at ____________________________.