COOKIE PROGRAM CAREGIVER AGREEMENT

COOKIE PROGRAM CAREGIVER AGREEMENT
My Girl Scout, Girl Scout Name* , a member of Troop Number, Troop Number* has my permission to participate in the 2025 Girl Scout Cookie Program.
Troop Cookie Manager Email Address*
example@example.com
Please read and agree to each statement below:
I will ask for a copy of the cookie receipt for pickup of any cookies and funds submitted, if not provided by the troop cookie manager*

Yes
I will ensure that my Girl Scout has adult guidance at all time during the cookie program.*

Yes
I will submit all funds received for payment for my Girl Scout's cookie sales to the troop cookie manager by required deadline*

Yes
All cookies obtained for my Girl Scout's sales will be picked up and paid for no later than March 16, 2025.*

Yes
My Girl Scout will NOT take cookie orders until January 6, 2025.*

Yes
I understand that I cannot return cookies or exchange cookies, and I agree to accept full financial responsibilities for all cookies that I order. If I am in need of assistance with selling the remaining cookies, I will contact the troop cookie manager in a timely manner.*

Yes
I understand that should any of my cookies or cookie moneyget lost, stolen, or damaged, I am fully responsible for the funds. If I needhelp, I will reach out to Girl Scout Central Indiana council via the Product Program Issue Form located on the web page under Cookies– Volunteer - Forms*

Yes
I understand that if I do not pay for the full amount of money due for cookies, I will be subject to legal prosecution and any fees incurred.*

Yes
I will not collect payment from a customer until cookies are delivered*

Yes
Caregiver Information
Caregiver Name*

First NameLast Name
Caregiver Date of Birth:*

MonthDayYear
Date
Caregiver Cell No. *
Please enter a valid phone number.
Caregiver Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Caregiver Email Address*
example@example.com
Place of Employment*
Work Phone Number*
Please enter a valid phone number.
Preferred Form of Contact:*

Text MessageEmailPhone Call
Caregiver Signature*

Clear
Date*

MonthDayYear
Date
VOLUNTEER OPPORTUNITIES
I can assist the troop cookie manager in the following ways (click those that appy):

Cookie booth chaperone (2025 membership required)Cookie delivery assistantOther
Should be Empty:

COOKIE PROGRAM CAREGIVER AGREEMENT

Please read and agree to each statement below:

Caregiver Information

VOLUNTEER OPPORTUNITIES