Girl Scouts During School Registration Halcyon Elementary School
GIRL INFORMATION
Girl Name
*
First Name
Last Name
Birth Date
*
Please select a month
January
February
March
April
May
June
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September
October
November
December
Month
Please select a day
1
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Day
Please select a year
2026
2025
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2021
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2015
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2012
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Year
Ethnicity
*
Please Select
American Indian or Alaskan Native
Asian
Black or African American
Hawaiian or Pacific Islander
White
Other Races
I choose not to share
Grade
*
Please Select
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Sixth Grade
School
*
Halcyon Elementary
CAREGIVER INFORMATION
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Guardian Email
*
example@example.com
Media Permission: When participating in Girl Scout activities my child may be photographed or recorded on video. Images may be used in promotion materials, news releases, and other published formats for either the local Girl Scout Council or Girl Scouts of the USA. The images will be the sole property of the local Girl Scout Council or Girl Scouts of the USA.
Check here to opt out
The cost for your girl to participate in this program is at a reduced cost of $10 which includes a t-shirt. Please choose size needed below
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My daughter will be participating in the Girl Scout Program at her school.
$
10.00
Show your Girl Scout Spirit with a t-shirt!
$
Free
Quantity
1
Size
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Payment Methods
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