NSM Girl Scouts Kentuckiana Winter Olympic Games
Monday, January 5, 2026
6:00 - 7:00 PM
Troop or Team Name
Troop Name
Add your child's troop name so we can group everyone together
Scout
Scout Name
*
First
Last
Date of Birth
*
Please select a month
January
February
March
April
May
June
July
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December
Month
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Day
Please select a year
2022
2021
2020
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2018
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2016
2015
2014
2013
2012
2011
Year
T-shirt Size
*
YOUTH XS
YOUTH SM
YOUTH MD
YOUTH LG
YOUTH XL
ADULT SM
ADULT MD
ADULT LG
ADULT XL
Tagalong
A friend or sibling
Scout Name
*
First
Last
Date of Birth
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
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31
Day
Please select a year
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
Year
T-shirt Size
*
YOUTH XS
YOUTH SM
YOUTH MD
YOUTH LG
YOUTH XL
ADULT SM
ADULT MD
ADULT LG
ADULT XL
Troop Leader
Troop Leader Name
First
Last
Date of Birth
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
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31
Day
Please select a year
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
Year
T-shirt Size
YOUTH XS
YOUTH SM
YOUTH MD
YOUTH LG
YOUTH XL
ADULT SM
ADULT MD
ADULT LG
ADULT XL
Troop Volunteer
Troop Volunteer
First
Last
Date of Birth
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
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23
24
25
26
27
28
29
30
31
Day
Please select a year
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
Year
T-shirt Size
YOUTH XS
YOUTH SM
YOUTH MD
YOUTH LG
YOUTH XL
ADULT SM
ADULT MD
ADULT LG
ADULT XL
Parent/Guardian
of the Scout and/or Tagalong
Parent/Guardian Name
*
First
Last
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
How did you hear about Girl Scout Skate Day?
Louisville Skating Academy Release, Waiver of Liability, Assumption of Risk, Covenant Not to Sue and Indemnity Agreement (“Agreement”)
Signature
*
I agree to the Louisville Skating Academy WAIVER & RELEASE
Louisville Skating Academy PHOTO/VIDEO/MEDIA RELEASE
Signature
*
I agree to the Louisville Skating Academy PHOTO/VIDEO/MEDIA RELEASE
Payment
*
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NSM Girl Scouts Kentuckiana Winter Olympic Games Product Name
$25/ person for Scouts, Troop Leader, Troop Volunteer or Tagalong
$
25.00
Quantity
1
2
3
4
5
6
7
8
9
10
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
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