Girl Scout Registration Form

Girl Scout Registration Form
Name
First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Date of Birth
MonthDayYear
Date
Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
Number of Years as a Girl Scout
School Grade
- When I (or the person I'm registering) participate in Girl Scout activities, I agree to be interviewed, photographed, recorded, or electronically imaged for promotional materials, press releases, or other published formats for either the local Girl Scout councils or Girl Scouts of the USA.
- I hereby release and hold the local Girl Scout council and the Girl Scouts of the United States of America free from any liability arising from the use of these photos.
- I will do my best to be truthful and fair, kind and helpful, considerate and caring, courageous and strong, and accountable for what I say and do, as well as to respect myself and others, respect authority, wisely use resources, make the world a better place, and be a sister to every Girl Scout.
I/We agree that the registrant will accept the Girl Scout Promise and Law and will follow it. The registrant is allowed to join the Girl Scouts.
Date
MonthDayYear
Date
Parent/Guardian Name
First NameLast Name
Parent/Guardian Signature
Clear
Should be Empty: