Caregiver Permission Form: 2022- 2023 Membership Year

Caregiver Permission Form: 2022-2023 Membership Year
We are so excited to have your Girl Scout join us for an exciting year including the Girl Scout Product Programs!

In an effort to reduce paper and reduce contact we have moved our Product Program agreement forms online! Please complete the below information granting your Girl Scout permission to participate in the Fall and/or Cookie Program.

Should your Girl Scout be a part of multiple households each Caregiver should complete their own agreement to avoid any liability disputes.

You can check out our website for full details:

Fall Program: gsmw.org/fallresources
Cookie Program: gsmw.org/cookieresources
IMPORTANT: Please have your Troop Number and Troop Leader information (name and email address) of your Troop Leader handy as they are required for this form. Unsure? Contact our Customer Care team and they can look it up for you: 800-736-5243 or customercare@gsmw.org.
Girl Scout Name*

First NameLast Name
Troop Number*
Troop Leader / Product Manager Name*

First NameLast Name
Troop Leader Email Address*
example@example.com
Caregiver Name - Person Completing Form*

First NameLast Name
Caregiver Email Address*
example@example.com
Caregiver Primary Phone Number*
Please enter a valid phone number.
Caregiver Secondary Phone Number
Please enter a valid phone number.
Caregiver Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
I am willing to volunteer to help my Troop in the following ways (check all that apply, an asterisk* indicates that a Girl Scout membership and background check is required).

Troop Fall Product Manager Assistant*Troop Cookie Manager Assistant*Cookie Delivery AssistantCookie Reward DistributionCookie Booth Chaperone*Booth Decoration HelperOther

Money & Receipting Process
- Money is collected when cookies are delivered, except for online orders, which are already paid by credit card at the time of the order.
- Customers should make checks payable to your Troop.
  Example: Girl Scouts of MT & WY Troop 12345 or GSMW Troop 12345.
- If using the Clover Go credit card processing app, these funds should still not be collected until delivery of the ordered packages. Funds will be deposited directly into troop account.
- Do not write one personal check to the Troop for all your orders.
- Do not keep large amounts of cash laying around. Make frequent visits to your Troop Cookie Manager to give them money to take to the bank.
- Protect yourself! Every time that you pick up cookies from your Troop Cookie Manager and/or give them money, be sure to get a receipt. Keep all of your receipts for your records. Do not take product from your Troop Cookie Manager or give them money without also receiving a receipt in return.
- Remember: Product cannot be returned or exchanged. Caregivers are financially responsible for all product ordered.
- You are responsible for lost or stolen funds.
- Any donations made should be accounted for and the funds turned in with your other payments.
Please sign below signifying your understanding of the Money & Receipting Process. *

Clear

Permission Terms

I agree to the following:
- I give permission for my Girl Scout to participate with the GSMW Product Program(s) during the 2022-2023 membership year.
- I will ensure that my Girl Scout has adult guidance at all times during the program.
- My Girl Scout will not take orders until the program begins.
- I will not collect payment from a customer until the product is delivered.
- I will ask for a copy of the receipt for pickup of any product and funds submitted, if not provided by the Troop Product Manager.
- I will submit all funds received for payment of my Girls Scout's sales to the Troop Product Manager by their required deadlines.
- All product obtained for my Girls Scout's sales will be picked up and paid for no later than the program end date.
- I understand that I cannot return product once they are ordered by my Troop, and I agree to accept full financial responsibilities for all of the product that I order. If I am in need of assistance with selling the remaining product, I will contact the Troop Product Manager in a timely manner.
- I understand that should any of my product or money get lost, stolen or damaged, I am still fully responsible for the product and funds.
- I understand that if I do not pay for the full amount of money due for product, I will be subject to the collections process.
- Free Camp Earners: Balances must be paid by May 31st, 2023 to retain the free camp. Free Camp must be used in 2023.
- Higher rewards are sent after balance is paid in full. Balances must be paid by July 31,2023 to retain rewards.
Please sign below signifying your understanding of the Permission Terms. *

Clear

Cookie Reward Selections

We know that each girl is different and while we can't create a reward line up that every girl will love we try to offer choices to better suit our girls unique interests!

Please review the options below with your Girl Scout and set a goal! Don't worry you can change your choices later by talking with your Troop Cookie Manager this just helps them by having the information in advance, AND gets your Girl Scout excited!

If a girl would like to select the GS Gift Card, girls may choose between a G.I.R.L. Card OR a GSUSA Online Store Card.

G.I.R.L. Cards nay be used to pay for Council Programs and Camps, GSMW Shop purchases, Girl Scout Memberships, Girl Scout Destinations and International Travel and Council Approved Troop Trips. The GSUSA Online Store Card is a digital gift card code and will be emailed to the primary caregiver of each Girl Scout choosing this option. This email will include instructions on how to redeem the GSUSA Online Store Card.

Cadette, Senior, Ambassador Troops may make a decision as a troop to opt out of rewards. Please check with your Troop Cookie Manager for more information.
Is your Troop opting out of Cookie Rewards? (Troops that opt out of the rewards will still earn their patches)

Yes, out Troop has decided to opt out for higher proceedsNo, we would like to earn the rewardsI'm not sure what my Troop's plans are yet
T-Shirt Size (see chart below for size guide)*
If my Girl Scout sells more than 150 packages, she would like to chose:
If my Girl Scout sells more than 200 packages, she would like to chose:
If my Girl Scout sells more than 250 packages, she would like to chose:
If my Girl Scout sells more than 325 packages, she would like to chose:
If my Girl Scout sells more than 400 packages, she would like to chose:
If my Girl Scout sells more than 500 packages, she would like to chose:
If my Girl Scout sells more than 600 packages, she would like to chose:
If my Girl Scout sells more than 800 packages, she would like to chose:
If my Girl Scout sells more than 1000 packages, she would like to chose:
If my Girl Scout sells more than 1250 packages, she would like to chose:
If my Girl Scout sells more than 1500 packages, she would like to chose:
If my Girl Scout sells more than 2021 packages, she would like to chose:
If my Girl Scout sells more than 2500 packages, she would like to chose:
If my Girl Scout sells more than 3000 packages, she would like to chose:
Should be Empty:

Caregiver Permission Form: 2022-2023 Membership Year