M DREAM INWORLD LIMITED (Incorporated in the Cayman Islands with limited liability) FORM OF PROXY Form of proxy for use by shareholders at the extraordinary general meeting of M Dream Inworld Limited to be held at Phoenix Room, The Charterhouse Hotel, 209-219 Wanchai Road, Hong Kong on Thursday, 29 October 2009 at 10:00 a.m. and at any adjournment thereof. (note b) shares of HK$0.0
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Microsoft powerpoint - belleplaine_sp_2008_permission_slip_032608Troop 53 Camping Activity
Belleplain State Park
Friday, April 23th to Sunday, April 25th
We’re going fishin’! We’ll be camping at Belleplain State Park in New Jersey near Cape May, approximately a
2- hour drive from Kennett Square. We’ll leave on Friday for our campsite. On Saturday, we’ll all get up early,
drive to Wildwood, and board a large fishing boat for 5 hours of deep sea fishing. All fishing equipment and bait
will be provided. Who knows what we’ll catch! We’ll return to camp in late afternoon. All will have a BLAST!
To see the boats Google the “Starlight Fleet” PS we’ll have boat just for us.
Skills, Advancement Opportunities, Special Information:
All scouts will all have advancement opportunities. Bring your Boy Scout Handbook. Departure Date/Time/Place/Uniform:
FRIDAY, April 23th, 2010
SUNDAY, April 25th, 2010
Meet at 5:30 PM SHARP (Depart 6:00 PM) Arrive back at 11:00 AM
Troop 53 Scout House
Cost Per Scout :
$45 for scouts (includes charter fishing) $25 for adults that go fishing (other driver adults are free) Meals Provided (Note: Scouts should eat dinner on Friday prior to departure):
Saturday LunchSaturday Dinner & Snack Personal Equipment Notes:
Bring your sleeping bag & air mattress for tent camping. Fishing rod is optional. Day pack is highly recommended. Bring a camp chair for relaxing around campfire. Be prepared! Parent/Guardian consent is required for this trip. Detach and return by Wednesday, April 14th
Yes, I will attend! My name is:
I can attend and drive (circle one) YES
If NO, you must provide an emergency contact number: Home #:
Please ensure that my son takes the following medications while on this trip: I authorize Troop 53 to offer to my son motion sickness medicine (Dramamine). (He will not be required to take it.): I give consent for the adult leaders of Troop 53 to act on my behalf should emergency medical treatment become necessary for my son while he is in their care on this trip. I understand that the purpose of the treatment is to stabilize my son’s medical emergency and may entail such measures as stitches, x-rays, and other emergency procedures administered by trained emergency personnel. I understand that an adult leader will attempt to contact me as soon as possible in the event of an emergency and that I will be involved in all decisions from the time I am reached. Should I be unavailable at the emergency number provided above, I, again, state, and by signing below, give my consent for the adult leaders of Troop 53 to act on my behalf in the provision of emergency care for my son.
Parent/ Guardian Signature:
NO MEDICATION ABBREVIATIONS UNAPPROVED ABBREVIATIONS U, IU, QD, or qd, QOD or qod, qn, ug, BT, > or <, Allergies: MEDICATION, DIET, TREATMENT, LAB ORDERS 1. Sign consent for: Left Right with Possible PCI 2. Old charts to accompany patient to cath lab 3. If patient had previous coronary bypass surgery, please obtain previous bypass surgery report. 4. Clip both groin areas. 5.