New Adult Girl Scout Member Registration

Adult & Lifetime Membership Registration

Girl Scouts builds girls of courage, confidence and character who make the world a better place. Be the adult a girl remembers for the rest of her life.
Contact Information
Name*

First NameLast Name
Birth Date*

MonthDayYear
Email*
example@example.com
Cell Phone*
Please enter a valid phone number.
Alternate Phone Number
Please enter a valid phone number.
FemaleMaleI choose not to share

Address*

Street Address

Street Address Line 2

CityState

Zip Code

Adult Member Demographics

Girl Scouts respects and welcomes people from all backgrounds and abilities. By completing the following information (as defined by the U.S. Census Bureau), you ensure support and funding for Girl Scouts in your community. Hispanic/Latina is defined as an ethnicity, not a race, and therefore is reported separately. This information is used for statistical purposes only.
Ethnicity*
Race*
Information used for demographic purposes only.

MEDIA PERMISSION: I give consent on my behalf and on behalf of the person I am registering to be interviewed, photographed, videotaped, or electronically imaged when participating in Girl Scout activities for use in promotional materials, news releases, or other published formats by my local Girl Scout council and/or Girl Scouts of the USA. The images will be the sole property of my local Girl Scout council and/or Girl Scouts of the USA. I and my heirs, successors and assigns hereby release and hold harmless my local Girl Scout council and Girl Scouts of the USA from any claim arising from the use of these materials.*

YesNo

Select Adult or Lifetime Membership option to complete registration. Membership fees are non-transferable and non-refundable.*

Annual Adult Membership

Annual Girl Scout Adult Membership valid October 1 through September 30.

$30.00

Young Alum (age 18-29) Lifetime Membership

One-time (lifetime) membership dues for adults age 18-29.

$200.00

10 Year+ Lifetime Membership

One-time (lifetime) membership dues for adult members with 10 or more years of volunteer service with Girl Scouts. Does not include years as a girl member.

$200.00

Lifetime Membership

One-time (lifetime) fee of $400 for adults 18 years or older.

$400.00

Total

$0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Should be Empty:

Adult & Lifetime Membership Registration

Contact Information

Adult Member Demographics

Girl Scout Troop

Become a Girl Scout Volunteer