Girl Scout Troop #
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Troop Leader Name
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First Name
Last Name
Troop Leader Email
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example@example.com
Troop Leader Phone Number
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Please enter a valid phone number.
How many Girl Scouts will be attending?
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A minimum of 4 troop members is required to participate.
Select Your Arrival Time
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🍪 Cookie Requirement Acknowledgement
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I understand and agree that Valeri Orthodontics and Children's Dentistry of Kenosha will purchase one (1) case of Girl Scout cookies per troop, and our troop will bring one (1) full, unopened case of Girl Scout cookies to the event.
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