Eichold Mertz Elementary Registration

Girl Scouts During School Registration Eichold Mertz Elementary
GIRL INFORMATION
Girl Name*

First NameLast Name
Birth Date*

MonthDayYear
Ethnicity*
Grade*
Eichold Mertz Elementary
CAREGIVER INFORMATION
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Email*
example@example.com
Check here to opt out

The cost for your girl to participate in this program is at a reduced cost of $10. Please check the box and it will be added to your cart. You can also choose to add a t-shirt for an additional $8.50

My daughter will be participating in the Girl Scout Program at her school

$10.00 Quantity

Show your Girl Scout Spirit with a t-shirt.

T-shirts are $8.50. If you do not want a shirt please choose NO THANK YOU and you will not be charged.

$8.50 QuantitySize

Enter coupon

Total

$0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

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Girl Scouts During School Registration Eichold Mertz Elementary

GIRL INFORMATION

CAREGIVER INFORMATION