Council Activity Approval Application

Type of application

High-Risk Activities - Submit 2 months in advance of activityTrips: 2 nights *or less* with high-risk activities - Submit 2-4 months in advance of activityTrips: 3 nights *or more* with high-risk activities - Submit 2-4 months in advance of activityTrips: 3 nights *or more* without high-risk activities - Submit 2-4 months in advance of activityInternational Travel & Cruises - Submit 12-24 months in advance of activityTroop Camping and Camporee - Submit 8-12 months in advance of activitySU Events or Events with Non-members and/or Tagalongs - Submit 2-4 months in advance of activity

Name*

First NameLast Name

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

Address*

Street Address

Street Address Line 2

CityState

Zip Code

County*

Troop Number*

Service Unit Name/Number*

Service Unit Name

Service Unit Number

SU Director Name*

Name of Event/Activity*

Trip Destination

Location of Event

Address of Lodgings

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Type of accommodations during travel and at destination

Are you required to sign any type of document to use this location?

YesNo

What program-level girls can/are assisting on this committee?

How will they be involved in the planning?

Please specify activities planned and how they will be executed

What are the special qualifications for participation?

Registered Adult Volunteers Helping with the Committee? Name, Email, Troop #

What is this event in support of?

How do you plan to advertise for this event?*

Participation Fee*

Total Income Projected*

Total Expense Projected*

Left Over Funds*

How will left over funds be used?*

The number of registered girls attending*

	Attending
Daisies
Brownies
Juniors
Cadettes
Seniors
Ambassadors
Registered/approved adults

Non-Girl Scouts Attendees

	Attending
Children
Audlts

Date(s) of Activity

Is this an overnight activity?

YesNo

Activity End Date

What type of event is this?

In-PersonVirtual

Preliminary Budget

	Cost
Food/Beverage
Program Supplies
Copy/Print Charges
Thank You Tokens
Recognitions
Rental of space
Additional Insurance
Other Expenses

Age Range of registered girls attending?

Date Troop Leaving

Date

Date Troop Returning

Date

Types of activities

More activities

If Other, please provide details

Number of Registered Adult Leaders Attending the Trip

	Attending
Females
Males

Registered Adults Attending Info

	Adult Leader 1	Adult Leader 2	Adult	Adult	Adult
First Name
Last Name
Email
Phone

First Aider(s)

	First and Last Name	Email	Troop#	Type of Cert.
First Aider 1
First Aider 2

Travel 2 Night or Less/3 Night or More

Required Leader Courses: Safety 1st, Planning Beyond the Troop w/ Emergency Preparedness, Day Trips & Overnight

Camporee, Troop Camping or SU Events

Required Leader Courses: Safety 1st, Planning Beyond the Troop w/ Emergency Preparedness, Day Trips & Overnight

International Travel

Required Leader Courses: Globe Trotting w/Girls, Planning Beyond the Troop w/ Emergency Preparedness, Day Trips & Overnight

High Risk Activity

Required Leader Courses: Safety 1st, Planning Beyond the Troop w/ Emergency Preparedness

Required Courses

	Name of Course	Date Taken
Course 1
Course 2
Course 3

Trip Budget

Cost of Trip Per Person

Trip Itinerary

Amount Earned by Troop

Amount Contributed by Parents

How did the girls earn the money?

Treats & KeepsCookie ProgramOther

If Other, please provide details

Will you have a current Minor & Adult Health History for each girl and adult participating in the trip or activity?

YesNo

Will you have parent support and a signed permission form for each girl participating in the trip?

YesNo

Have you read the GSGATL Safety Activity Handbook found on our website that pertain to all planned activities, and do you understand them and agree to follow them?*

Yes, and Agree

Will the skill level of each participant been evaluated if required by the Safety Activity Checkpoint?

YesNo

Is specialized equipment being used that you will have to provide? If yes, please list.

YesNo

List of Specialized Equipment

Are special agreements, contracts, liability waivers, hold harmless, or release documents required for any activity?

YesNo

Required special agreements, contracts, liability waivers, hold harmless, or release documents

Are you using a travel agent?

YesNo

Travel Agent Details

How are you traveling?

Private Passenger VehiclesRental Vehicles (15 passenger or less)Other Transportation

Other Transportation Details

Upload Files that are pertinent to this application

My signature indicates that the information found on this application is true to the best of my knowledge.*

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