Juliette Product Program Permission Form

Juliette 2025 Fall Program Permission Form
We are so excited to have your Girl Scout join us for an exciting year including the Girl Scout Product Programs!

In an effort to reduce paper and reduce contact we have moved our Product Program agreement forms online! Please complete the below information granting your Girl Scout permission to participate in the 2025 Fall Program.

Should your Girl Scout be a part of multiple households each Caregiver should complete their own agreement to avoid any liability disputes.
Girl Scout Name*

First NameLast Name
Juliette Mentor Name*

First NameLast Name
Email Address*
example@example.com
Caregiver Name - Person Completing Form*

First NameLast Name
Caregiver Email Address*
example@example.com
Caregiver Primary Phone Number*
Please enter a valid phone number.
Caregiver Secondary Phone Number
Please enter a valid phone number.
Caregiver Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Money & Receipting Process
- Money is collected when product is delivered, except for online orders, which are already paid by credit card at the time of the order.
- Customers should make checks payable to GSMW. GSMW does not accept customer checks for more than $200.
- If using the Clover Go credit card processing app, these funds should still not be collected until delivery of the ordered packages. Funds will be deposited directly into GSMW Depository Account.
- Do not keep large amounts of cash laying around.
- Submit regularly. GSMW does not cover NSF fees for checks dated more than 30 days from the deposit date.
- Protect yourself! Every time that you pick up product, be sure to get a receipt. Keep all of your receipts for your records.
- Remember: Product cannot be returned or exchanged.
- Caregivers are financially responsible for all product ordered.
- You are responsible for lost or stolen funds.
- Please refer to your 2025 Cookie Program Guide for Juliettes on how to submit money.
Please sign below signifying your understanding of the Money & Receipting Process. *

Clear

Permission Terms

I agree to the following:
- I give permission for my Girl Scout to participate with the GSMW 2025 Cookie Product Program.
- I will ensure that my Girl Scout has adult guidance at all times during the program.
- My Girl Scout will not take orders until the program begins.
- I will not collect payment from a customer until the product is delivered.
- I will ask for a copy of the receipt for pickup of any product.
- I will submit all funds received for payment of my Girls Scout's sales to GSMW by their required deadlines.
- All product obtained for my Girls Scout's sales will be picked up and paid for no later than the program end date.
- I understand that I cannot return product once they are ordered, and I agree to accept full financial responsibilities for all of the product that I order. If I am in need of assistance with selling the remaining product, I will contact the Juliette Coordinator in a timely manner.
- I understand that should any of my product or money get lost, stolen or damaged, I am still fully responsible for the product and funds.
- I understand that if I do not pay for the full amount of money due for product, I will be subject to the collections process.
Please sign below signifying your understanding of the Permission Terms. *

Clear
Should be Empty:

Juliette 2025 Fall Program Permission Form