Sign-up for the most epic year yet, become a Girl Scout!
Just a little information is all we need to get your new membership completed or renew your current membership.
Adult Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are you joining for for the first time or renewing for another year of fun
1st time!
Renew me now!
Birthdate
-
Month
-
Day
Year
Why do we ask? If you volunteer or help with the troop this is needed to get you started with your background screening.
Would you like us to text you regarding exciting participation information?
*
Yes
No
Are you also registering or renewing a girl today?
Yes
No
How would you like to participate as a member?
Volunteer to lead a troop
Volunteer to help with a troop
Volunteer in other ways
Be an adult member without volunteering
Do you have the Simply Healthcare Florida Healthy Kids plan? ***Simply Healthcare plan members with a Florida Healthy Kids plan can choose to receive a free girl membership valid Oct 1 2020 - Sept 30 2021.*
Yes
No
Is your girl/s with the Florida Healthy Kids plan who is receiving the free membership already a member for 2021 which started on October 1, 2020? ***Current members who already purchased a 2021 membership will receive a 2nd year of membership for free valid Oct 1 2021 - Sept 30 2022***
Yes
No
Upload a copy of your girl's Simply Healthcare plan card for verification.
Browse Files
Cancel
of
Girl #1 Name
*
First Name
Last Name
Girl #1 Birthdate
*
-
Month
-
Day
Year
This is required to place her in the appropriate age level program.
Girl #1 Grade as of Fall 2020.
*
K
1
2
3
4
5
Let us know which ways your girl/s would like to participate:
*
I would like to start an in-person troop with my girl.
I would like to find an in-person troop my girl can join.
My girl would like to participate as an individual member.
I would like to join a virtual troop.
I'm not sure, please contact me.
Do you have a specific troop for Girl #1 to join?
*
Yes
No
Troop #
Girl #2 Name
First Name
Last Name
Girl #2 Birthdate
-
Month
-
Day
Year
This is required to place her in the appropriate age level program.
Girl #2 Grade as of Fall 2020.
K
1
2
3
4
5
Let us know which ways your girl/s would like to participate:
I would like to start an in-person troop with my girl.
I would like to find an in-person troop my girl can join.
My girl would like to participate as an individual member.
I would like to join a virtual troop.
I'm not sure, please contact me.
Do you have a specific troop for Girl #2 to join?
Yes
No
Troop #
Girl #3 Name
First Name
Last Name
Girl #3 Birthdate
-
Month
-
Day
Year
This is required to place her in the appropriate age level program.
Girl #3 Grade as of Fall 2020.
K
1
2
3
4
5
Let us know which ways your girl/s would like to participate:
I would like to start an in-person troop with my girl.
I would like to find an in-person troop my girl can join.
My girl would like to participate as an individual member.
I would like to join a virtual troop.
I'm not sure, please contact me.
Do you have a specific troop for Girl #3 to join?
Yes
No
Troop #
Membership Products
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Girl Membership - Oct 1 2020 thru Sept 30 2021.
$
25.00
Quantity
1
2
3
4
5
6
7
8
9
10
Adult Membership - Oct 1 2020 thru Sept 30 2021.
$
25.00
Quantity
1
2
3
4
5
6
7
8
9
10
Simpy Healthcare Girl Membership - Oct 1 2020 thru Sept 30 2021.
This is only available for Simply Healthcare plan participants who have a Florida Healthy Kids plan and is limited to girl memberships only. Each girl requesting a free membership must submit a copy of the Simply Healthcare plan card to be eligible.
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
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Credit Card
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