Hopkins District Cub Scout Day Camp 2009 � An all-volunteer program

�Cubs in Space�

Transportation Form

Scout Name (goes by)_________________________________________________________________

Street Address______________________________________________________________________________

City/State/Zip Code_________________________________________________________________________

Home Phone Number________________________________________________________________________

Father�s Name_____________________________ Mother�s Name_____________________________

Father�s Home Phone_______________________   Mother�s Home Phone_______________________

Father�s Work Phone_______________________    Mother�s Work Phone________________________

Father�s Cell Phone_________________________  Mother�s Cell Phone_________________________

Father�s Pager_____________________________   Mother�s Pager_____________________________

The additional following people have my permission to transport my child to and/or from Hopkins District CSDC 2009, held at Clifton Park.

Name_____________________________________________________________________________________

Relationship_______________________________________________________________________________

Phone Number_____________________________________________________________________________

Name_____________________________________________________________________________________

Relationship_______________________________________________________________________________

Phone Number_____________________________________________________________________________

Name _______________________________________________________________________________

Relationship_______________________________________________________________________________

Phone Number_____________________________________________________________________________

Name_____________________________________________________________________________________

Relationship_______________________________________________________________________________

Phone Number_____________________________________________________________________________

Name_____________________________________________________________________________________

Relationship_______________________________________________________________________________

Phone Number_____________________________________________________________________________

Name_____________________________________________________________________________________

Relationship_______________________________________________________________________________

Phone Number_____________________________________________________________________________

*** Note: No one is allowed to transport your child from Camp but his or her parents/guardians or those persons listed above.

Parent Signature:___________________________________________________ Date:___________________

(not valid without Signature)

 



 

 Hopkins District BAC-BSA - 701 Wyman Park Drive, Baltimore MD 21211 - Phone (443)-573-2527 -
Fax (443)-573-2627