Program Pack Registration Form

Complete the form below to register your girl for the GSHNC Program Pack!
Caregiver Information
Caregiver Name

First NameLast Name
Email Address

Confirmation Emailyouraddress@service.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Phone Type
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Caregiver Birth Date

MonthDayYear
Date
Caregiver Gender
Caregiver Relationship to Girl
Girl Information
Girl Name

First NameLast Name
Girl Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
School Grade
If today is BEFORE August 1, enter the grade they are completing. If today is August 1 or after, enter the grade they will be going into.
School Attending
Girl Birth Date

MonthDayYear
Girl Email
Girls over 13 may provide an email address to also receive emails from GSUSA and GSHNC.
Girl Phone Number
Girls over 13 may provide a phone number to also receive texts from GSUSA and GSHNC.Format: (000) 000-0000.
Phone Type
Age
Demographic Information

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 girls in your community. Hispanic/Latina is defined as an ethnicity, not a race, therefore is reported separately. This information is anonymized and used for statistical purposes only.
Girl Ethnicity
Girl Race
Caregiver Ethnicity
Caregiver Race
Policies, Terms, and Conditions
Review the GSUSA privacy policy
Review the Terms and Conditions
Review the Girl Scout Child Abuse Prevention policies and procedures.
Order Summary
Your Program Pack membership with Girl Scouts, Hornets' Nest Council includes:
- Girl Scout membership valid until 9/30/2027.
- Program Pack discounts:
  - Provides $10 off any* program hosted by Girl Scouts, Hornets' Nest Council.
  - Member pricing on Summer Camp sessions.
  - Member pricing on events with our program partners, such as Carowinds and the Charlotte Crown.
- Access to Girl Scouts, Hornets' Nest Signature programs including SheBiz and Cookie Rally.
*Note that we serve girls in kindergarten through 12th grade and most programs are designed for specific age ranges. Girls cannot attend programs that aren’t for their grade level.
Payment Amount
USD
Order Date

MonthDayYear
Date
Membership Fee

prevnext( X )
USDProgram Pack Registration
PayPal Checkout includes an option to split your payment into four interest-free, bi-weekly payments. A free PayPal account is required to use this option.

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Should be Empty:

Caregiver Information

Girl Information

Demographic Information

Policies, Terms, and Conditions

Order Summary

Membership Fee

Payment Methods