Extended and International Troop Travel Application
This Application is used for domestic travel with a duration of three (3) or more nights and international travel of any length. This form must be submitted for approval at least five (5) weeks in advance of the date of departure for domestic travel, and twelve (12) months in advance for international travel. As of November 2023, additional insurance and non-scout insurance is NOT required for troop travel requests. Additional insurance and non-scout insurance is now covered under our basic plan for travel. Additional Sickness Coverage for extended and international trips is optional under Plan 3P. For a Travel Planning Checklist, Sample Itinerary, and additional information, please visit https://www.gskentucky.org/en/about-girl-scouts/our-program/ways-to-participate/travel.html.
Trip Coordinator
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Troop Information
Service Unit
*
Troop Number
*
Age Level of Girls
*
Daisy
Brownie
Junior
Cadette
Senior
Ambassador
Total Number of Participants
*
Number of Girls
*
Number of Registered Adults
*
Number of Non-Registered Person(s)
*
If pursuing applicable Plan 3P Sickness Coverage, upload Additional Insurance form here.
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Please provide a Roster of all adults and girls participating in the trip by typing their information below.
List GIRLS participating in the trip
*
List ADULTS participating in the trip
*
I have reviewed in Volunteer Essentials the required adult volunteer/girl ratios for Events, Travel, and Camping, and confirm that the minimum ratio will be met for this trip.
*
Yes
Trip Information
Trip Destination
*
Destination Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Departure Date
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Departing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Return Date
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Return Arrival Location
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
According to Safety Activity Checkpoint, will your troop be participating in any activities that require council approval/ high risk?
*
Yes
No
Description of High Risk Activities
Please upload high risk activity forms.
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NOTE: Make sure parent/guardian permission forms are collected prior to the trip, and girl health history forms are available to the first aider on the trip. If high risk activities are scheduled, include all participants high-risk activity forms with this application.
Transportation
Please note: The use of 12-15 passenger vans does not meet the GSKWR safety criteria and should not be used for transporting children.
What type of transportation will be used on the trip? (Select all that apply.)
*
Private Car(s)
Rented Car or Minivan
Chartered Bus
Airplane
Train
Boat/Ship
Other
Name of Rental or Bus Company (if applicable)
Driver Information
All adults who will be transporting girls other than their own daughters must be a registered member of Girl Scouts of Kentucky's Wilderness Road, and have a current background check.
*
Emergency Contact Information
Home Emergency Contact Person. Provide name of person at home to serve as troop contact in case of emergency. Please provide the emergency contact person with a copy of the itinerary, an emergency action plan and contact information for the caregivers of everyone attending. This person must be someone who is not attending the trip.
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
I have researched and identified the nearest hospital or emergency medical provider for the trip destination:
*
Yes
Adult Training and Certification
The Adults listed below are participating on this trip and have completed the necessary training for this trip.
First-Aid & CPR Certified Adult
*
First Name
Last Name
Please attached a copy of this certificate.
*
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Troop Camp Certified Adult
*
First Name
Last Name
Date of Completion
*
-
Month
-
Day
Year
Date
Planning Trips with Girl Scouts Trained Adult
*
First Name
Last Name
Date of Completion
*
-
Month
-
Day
Year
Date
Itinerary and Accommodations
Please upload an itinerary of activities including dates, approximate times, daily activities, and major sites or stops.
*
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Accommodations (Select all that apply.)
*
Hotel
Campsite
Private Rentals (Airbnb, VBRO, etc)
Other
Please provide the name and address for each overnight accommodation:
*
Budget
The troop treasury will pay:
$
Each participant will pay:
$
Total cost per person:
$
Please upload a detailed trip budget.
*
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Signature
I affirm that I have reviewed the travel requirements and applicable Safety Activity Checkpoints for this trip.
*
Yes
This trip has been planned with girl input at a level appropriate for the girls’ grade level and progression.
*
Yes
My signature below indicates that all the information provided is correct to the best of my knowledge. I also acknowledge that intentional failure to follow published guidelines and procedures found in the most current version of Volunteer Essentials and Safety Activity Checkpoints could result in a reduction of available Girl Scout provided insurance and may result in personal liability to myself. I understand that all travel approval is tentative until the final approval email notification is received.
*
Yes
Signature
Submit
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