Boy Scout Troop 112
September 2012 Ft. Ancient Campout Outing Information
Where:Ft.AncientState Memorial, 6123 State Rt. 350, Oregonia, Ohio45054
Dates :Sept. 7-9, 2012
Activities:Service project, followed by ziplining or canoeing
Departing: Friday from Mt.WashingtonPresb.Church at 5:30pm.
(EAT BEFORE YOU COME)
Saturday events (times are tentative):
8:30am –2pm Service project (long sleeves,long pants, work gloves)
3pm – 7pm Canoeing (Morgan’s) or Ziplining (Ozone Adventure at CampKern) - families are welcome at either activity at scout group rates
8pmFt Ancient Campfire
Returning:Sunday to Mt.WashingtonPresb.Church at 11:00am.
Please be prompt picking up your scout... Thank You
Costs (per person) for event:
$4 for camping - Additional fee will be charged by patrol for food.
PLUS$60 forzipliningOR $24 for canoeing
Food :Patrol cooking! Cooks need to submit their menu in advance to the Patrol Leader and patrolmembers will split the costs for the Patrol meals.
Adults will be eating as a group.
Leaders:Scoutmaster Jim Osborne /Asst Sr Patrol Leader Ross Osborne
cell number 513-227-8723email
Permission Slip Deadline:Sign up on registration sheet at scout meetings for canoe and zipline activitiesimmediately). Permission slips (page 2) for the outing will be acceptedthrough theTuesday, September 4scout meeting.
Troop Gear and personal gear for the outing will be loaded into the troop trailer at the Tuesday, September 4 scout meeting.
Boy Scout Troop 112
September 2012 Ft.Ancient Campout Permission Slip
Scout: ______has my permission to attend the BoyScout Troop 112 Ft. Ancient Campout on September 7-9, 2012.
Patrol Name: ______Rank: ______
Total Cost for Event:
Scout(s)$_____ x # attending ______= $______
Adult(s)$_____ x # attending ______= $______
Total Cost: $______
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Troop Leaders have my permission to authorize/provide Emergency Medical care, and to seek medical attention for my child/myself in case of medical emergency. Troop 112 leaders also have my permission to provide over the counter medication, and prescription I have provided (with specific directions for administering the prescription), as they deem appropriate.
Parents Signature: ______Date: ______
Parents Name: ______
Email address to use for information: ______
Emergency contact name: ______Phone Number: ______
(Please give the numbers where you can be reached during the event)
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Adultattending? (name)______
** have you completed the Youth Protection Program? Yes: ____ Date: ______
Ifnot- please go to and complete the Youth Protection classbefore this event.
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I am available to drive to the Event? Yes:___ No: ____
I am available to drive back from the Event? Yes:___ No: ____
How many seat belts do you have including driver’s seat? ______
* Troop 112 Driver form on file?Yes: ____ No: _____
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Are you a trained Scout Leader: Yes _____ No: _____
CPR training: Yes: ______Expiration date: ______
Forms can be found at 1 of 210/13/2018