| I, | give my son(s) |
| permission to attend the following scout event |
| on the following date |
| Circle one: I will will not be able to attend. | If adult is attending: |
| I am able to take | additional scouts/persons in my vehicle. |
| My liability insurance limits are |
|
| Vehicle make and model: | My vehicle registration number is | and my driver's license number is | Signature: |