Girl Scout Council Sponsored Product Program Parent/Guardian Permission Form
2023 Fall Program : Please read and complete the information below and return the form to your troop leader for every registered Girl Scout who participates in the council product programs. After completion please forward your confirmation to your Troop Leader, they retain the form for their troop records.
Girl Scout Information
Please complete the following information for your Girl Scout.
Name
*
First Name
Last Name
Troop Number
*
ex. 98765
Service Unit
*
County
*
Ex. Livingston
Grade Level:
*
Daisy (grades K-1)
Brownie (grades 2-3)
Junior (grades 4-5)
Cadette (grades 6-8)
Senior (grades 9-10)
Ambassador (grades 11-12)
Financial Responsibility
My Girl Scout has my permission to participate in the Girl Scout Fall Product Program.
*
I agree to accept the full responsibility for all product and money received for the fall product program.
I agree to pay the fall product program bill in full and on time to the troop leader/ volunteer. It is understood and agreed that in the event any outstanding balance has to be referred to a collection agency or attorney for recovery. I will be fully responsible for all collection agency fees and attorney's fees.
I understand the income from the pproduct programs does not become the property of individual girl members. Girls, however, may be eligible for incentives and credits that may be applied toward Council sponsored camps, programs, uniforms and memberships.
I have reviewed the Girl Scout Internet Safety Pledge and Product Sale-Safety Activity Checkpoints (visit gswny.org and select forms).
Girl Scout Law says, "I will do my best to be honest and fair." I agree that my Girl Scout will not sell prior to the first day of the fall product program and I will provide adult supervision for her during the sale.
Parent/ Guardian Information
Please complete the following information.
First Name
*
MI
Last Name
*
Address
*
City
*
Ex. Warsaw
State:
*
Ex. NY
Zip
*
Ex. 14620
Phone (cell)
*
Employer
*
Work Phone
*
Business Address
*
City
*
ex. Batavia
State
*
Ex. NY
Zip
*
ex. 14624
New York State Driver’s License
*
Email Address
*
example@example.com
Signature
I confirm that I have read, understand, agree to and will comply with all of the above expectations and financial responsibilities.
Signature
*
Date
*
/
Month
/
Day
Year
Date
Preview PDF
Submit
Should be Empty: