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pateckelmann@netzero.net  or by phone 718-930-6859   

ROYAL RANGER POW WOW PERMISSION SLIP

I ____________________________ GIVE PERMISSION FOR MY ___________   ________________________

       (PARENT OR GUARDIAN)                                                                (RELATIONSHIP)                  (BOY’S NAME)

TO ATTEND THE NEW YORK DISTRICT POW WOW AT THE DISTRICT ROYAL RANGER PROPERTY IN

GREENE, NEW YORK ON July 14 - 17, 2011.

SIGNED ___________________________

               (PARENT OR GUARDIAN SIGN)

DATE     ___________________________

I GIVE _______________________ PERMISSION TO PARTICIPATE IN ALL POW WOW ACTIVITIES AS

                        (BOY’S NAME)

STATED IN THIS PACKET AND POSTED ON THE NY ROYAL RANGERS WEB SITE.      

I ALSO UNDERSTAND THAT PHOTOGRAPHS OF THE BOYS ENJOYING THESE

ACTIVITIES MAY BE USED FOR PROMOTIONAL PURPOSES AT A LATER DATE.

NAMES WILL NOT BE INCLUDED.

NAME  _____________________________________________

(PARENT OR GUARDIAN)

ADDRESS __________________________________________

                   __________________________________________

                   __________________________________________

PHONE     ___________________________________________

OUTPOST # ________________CHURCH ____________________________________

CHECKLIST OF ITEMS FOR CAMPOUT

(See the other list, which is posted in this packet)

____ SLEEPING BAG                                                                                        ____ KNIFE, FORK & SPOON KIT

____ CHANGE OF UNDERCLOTHES FOR EACH DAY                 ____ FLASHLIGHT

____ CHANGE OF SOCKS FOR EACH DAY                                                 ____ JACKET

____ WORK OR HIKING SHOES                                                                     ____ CAP

____ SNEAKERS                                                                                                ____ PONCHO (RAIN GEAR)

____ EXTRA PANTS                                                                                          ____ LIMITED POWER OF ATTORNEY MEDICAL FORM

____ EXTRA SHIRTS OR T-SHIRTS                                                                ____ PRESCRIPTION MEDICATION(S) (TO BE GIVEN TO

____ RR UNIFORM AND BLACK SOCKS FOR INSPECTION                                     LEADER IN CHARGE AT THE START OF THE

____ TOILET KIT ARTICLES:                                                                                          TRIP.)

____     TOOTHBRUSH                                                                             ____ PERMISSION SLIP

____               TOOTHPASTE                                                                              ____ BIBLE

____                SOAP (INPLASTICBAG OR CONTAINER)                             ____  SWIM SUIT

____                WASHCLOTH

____                TOWEL

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