Klondike 2025

Completed BSA Health Forms (Parts A and B) must be on file with Troop 2220 for each person attending this campout.

2025 Klondike Derby

Event Details:

Event Date: January 25, 2025
Event: 2025 Klondike Derby
Location:Camp Snyder, 6100 Antioch Rd, Haymarket, VA 20169
Permission Slip Due: Tuesday, January 14th, 2025
Money Due: Tuesday, January 14th, 2025
Cost:$25/person plus cash for dinner
Description: Prince William and Burke Lake Distict's Klondike Derby
Bring:Cold weather gear: hat, boots, scarf, dress in layers
Meeting Time:Saturday, January 25th, 6:30 am at ACUMC

Other: Completed BSA Health Forms (Parts A and B) must be on file with Troop 2220 for each person attending this campout.

By completing this form you are granting permission for this child listed below to participate in the 2025 Klondike Derby with Troop 2220 during January 25, 2025.

Please provide all of the required information for the Scout attending this event. You will need to complete this form for each Scout, for which you are responsible.

Scout's First Name

Child’s Date of Birth

Scout's Last Name

Home Phone Number

Name of Parent(s)

Please provide the name of the parent or guardian of the Scout listed on this form.

Parent(s) Email Address

Please provide a primary email for parent or guardian of the Scout listed on this form.

In case of emergency: Primary Contact

Primary Emergency Contact Name

Primary Phone

If I can not be reached: Alternate Contact

Alternate Emergency Contact Name

Alternate Phone

Additional Information

Parent or Guardian is going

Yes No

Additional Notes for Leadership:

By submitting this form you give permission to the leaders of the above unit to render First Aid, should the need arise. In the event of an emergency, I also give permission to the physician, selected by the adult leader in charge, to hospitalize, secure proper anesthesia, order injection, or secure other medical treatment, as needed.

You further agree to hold the above named unit and its leaders blameless for any accidents that might occur during this outing except for clear acts of negligence or non-adherence to BSA policies and guidelines.

Klondike 2025

2025 Klondike Derby

Event Details:

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