By checking "NO", I understand that I will need to sign individual permission slips for each activity.

My child has permission to travel to, attend, and participate in troop and council-sponsored activities that are (1) a day trip, (2) less than 200 miles round trip, and (3) not considered high-risk activities as outlined by GSNYPENN. Leaders will notify care-givers of all planned activities with detailed information. I understand that my child may not attend any Girl Scout activities if showing signs of cough, fever or other symptoms of illness. I further understand that my child may be exposed to illness while participating in a Girl Scout activity, not unlike any other activity.
My child has permission to participate in virtual meetings. I understand that different platforms collect different information and have various privacies. It is my responsibility to review privacy settings.

My child has permission to participate in the fall and cookie programs. I agree to accept all financial responsibility for products and money she receives and deliver product in a timely manner. I understand that my Girl Scout must have adult guidance at all times when participating in the Girl Scout product programs. I further understand that my Girl Scout may only take orders during the assigned timelines set forth by GSNYPENN.

In the event of an emergency, every effort will be made to contact a parent/guardian/emergency contact person. If no contact can be made, I hereby give authorization to GSNYPENN and agents, to seek medical treatment for my child and/or dependent minor by a licensed professional. I know of no reason(s) why my child may not participate in activities as noted on the completed Health History Form on the back of this form.

If I cannot be reached, the following person(s) can act on my behalf:

I give consent to GSNYPENN to use my Girl Scout's name, image, and videos to be used in whatever they desire, including television, social media, websites, and communications. These materials shall be Girl Scouts' sole property.

When participating in Girl Scout activities I agree that my child (and I if applicable) is a registered members and will act in a manner that models the ideals and values of the Girl Scout Promise and Law. I have read and understand this Annual Permission Form. I may change or revoke any aspect of this agreement at any time by submitting my request, in writing, to the troop leader.

COVID-19 is an extremely contagious virus that spreads easily through person-to-person contact. As with any social activity, participation in Girl Scouts could present the risk of contracting COVID-19. While Girl Scouts of NYPENN Pathways takes every safety and preventative precaution, Girl Scouts of NYPENN Pathways can in no way warrant that COVID-19 infection will not occur through participation in Girl Scouts of NYPENN Pathways council or troop programs.

I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child (and I) may be exposed to or infected by COVID-19 at a Girl Scout activity and that such exposure or infection may result in personal injury, illness, perma- nent disability, and death. I understand that the risk may result from the actions, omissions, or negligence of myself and others including, but not limited to, Girl Scout volunteers, staff, and other participants and their families.

This health history is complete and accurate. My daughter has permission to engage in all prescribed activities except as noted by me and/or the examining physician.

THIS FORM MUST BE RETAINED BY THE TROOP AT ALL TIMES AND GO WITH THE PERSON NEEDING ANY EMERGENCY TREATMENT