District 3 - Fall Camporee - Gateway National Park

Registration Form - TURN IN BY MONDAY SEPTEMBER 29 !!!

My son, ____________________________________________

has my permission to attend the campout at Fort Hancock on Oct 10-12,
2003.  I accept full responsibility for him, relieving the leaders
of Troop 26 and the Burlington County BSA Council from any responsibility.
He will not attend if he is not feeling well.  Given any special medical
or health conditions listed below, First Aid and/or Emergency Medical
Treatment may be administered if necessary.

Please indicate any special medical / health conditions (if none,
so state):

______________________________________________________________

______________________________________________________________



_______________________________   _________________________
Signature of Parent / Guardian    Date

Phone Number where parent / guardian can be reached in case of
emergency:

____________________________________

If I cannot be reached, please contact:

_______________________________________ phone ___________________