Sea Base Bahamas High Adventure Trip
We, _____________________________________, the parents / guardians of _______________________________________
(Parents of Guardians Print Name) (Minor Participant)
Give our child, a resident minor of __________________________________________________________________________
Permission to accompany Boy Scout Troop/Crew ________High Adventure group to Marsh Harbour, Abaco, Bahamas
(Number) (Location)
From___________to____________and participate as a member of the group. We acknowledge that we are allowing
(Date) (Date)
our child to participate entirely upon our own initiative, risk and responsibility.
We further expressly authorize and consent to any x-ray examination, anesthetic, medical, or surgical diagnosis or
treatment, and/or hospital care under the general or special supervision, and on the advice of, a licensed physician,
surgeon, anesthesiologist, dentist or other qualified medical personnel acting under their supervision, for our child,
should the same become necessary because of illness or injury.
Now, therefore, in consideration of the permission extended to our child to accompany the High Adventure group
and participate in the trip, we do hereby for ourselves, our child, our heirs, executors and administrators, remise,
remise , release, and forever discharge the Boy Scout Troop/Crew_______, group leader(s):
(List the Leaders(s) First and Last Name(s))
As well as the __________________________Council, the BSA Florida Sea Base, the Boy Scouts of America, its officers,
members, as well as all other participants and sponsors of said High Adventure Trip, acting officially or otherwise, from
all claims, demands, actions or causes of action of any kind including the death of our child or any injury to our child or
loss or damage to property which may occur from any cause during the trip as well as all ground and flight travel incident
to such trip.
It is our intention by this document to consent to our child’s participation in the High Adventure trip, to consent
To all the group leader(s):_______________________________________________________________________
To act in loco parentis for the duration of the High Adventure trip; and to waive and forego all right of action of
ourselves and our child against the parties herein before named.
Executed in the presence of:
NOTARY PUBLIC IN AND FOR__________COUNTY____________ _____________________________________
(State) (Parent / Legal Guardian Signature)
Subscribed and sworn to before me this____day of_______, __________ _________________________________________
(NOTARY SEAL) ____________________________________
(Parent / Legal Guardian Signature)