Overnight Permission Form

Prior to any trip or program outside of the normal meeting place and time, your troop leader should provide you with information, including:

Itinerary
Costs
Transportation Arrangements
Names and Contact Info for Chaperones
Necessary Clothing or Equipment

In addition to this Permission Form, you should also complete an annual Health History and Consent to Administer Medical Treatment Form.

A copy of this form will automatically be emailed to your troop leader, please ensure you have entered the correct email address. Please note that Girl Scouts, Hornets' Nest Council does not retain a record of the information submitted in this form. This form can also be printed and submitted to your troop leader in person if you prefer.

Program/Trip *

Girl's Name *

First Name Last Name

Parent/Guardian Name *

First Name Last Name

Parent/Guardian Email *

Cell Phone Number *

Area Code Phone Number

Address *

Street Address

Street Address 2

City State

Zip Code Country

Troop Number *

Troop Leader Name *

First Name Last Name

Troop Leader Email *

example@example.com

Emergency Contact Name *

First Name Last Name

Emergency Contact Phone *

Area Code Phone Number

Emergency Contact Relationship to Girl *

Check all that apply: *

I have reviewed the trip information provided by the leader and give my girl permission to participate. My girl is able to participate in the activities as described, with or without accommodations. I have discussed any special needs or accommodations with my troop leader. I have completed and submitted an annual Health History and Consent to Administer Medical Treatment form to my troop leader. My girl may not participate in the following portions of the trip: (type in restrictions box below)

My girl may NOT participate in the following:

Parent/Guardian Signature

Overnight Permission Form

Contact Information

Permission