Please complete this form granting permission for your Girl Scout(s) participation in Girl Scouts of Historic Georgia's 2026 Fall Product and the 2027 Cookie Program. This form must be submitted before participation in the Product Programs. Completing this form does not require your Girl Scout to participate in both Product Programs.

Must complete one form per Girl Scout.

To celebrate our Girl Scouts' success, GSHG will be showcasing the top sellers of the season on social media! Your completion of this portion of the form will be seen as your consent to allow your Girl Scout's photo to be uploaded to social media.

By completing the next form, I am acknowledging the following:

• My girl is a registered Girl Scout for the 2027 membership year.
• I will communicate to the Troop Leader that my Girl Scout will be participating in a Product Program BEFORE she begins selling.
• I understand NO sales are permitted prior to the start of either Product Program.
• I will ensure my girl follows the Safety Guidelines (including, but not limited to, not posting to open online social media sites) and will always have adult guidance. I will follow all Safety Guidelines when using social media on behalf of my Girl Scout.
• I release Girl Scouts of Historic Georgia from any liability or damages incurred by my girl as a result of her participation in either the Fall Product Program or the Girl Scout Cookie Program.
• I understand that all proceeds are troop or council funds and are NOT the property of my girl in accordance with Girl Scouts of USA standards.
• I understand if no payment is made, actions will be taken against me with the local county magistrate court. I am liable for any amount not remitted plus legal costs expended by Girl Scouts of Historic Georgia.
• I understand my girl may not participate in future Girl Scout Product Programing if there is outstanding debt.
• I understand I must fill out and return the Caregiver Debt Procedure Form for my girl to participate in the Girl Scout Cookie Program. I understand that I'm responsible for all debt plus any other associated costs.
• I accept ALL financial responsibility for all products received from monies collected and agree to submit monies paid in full by the deadlines established by the Troop Product Program Manager.
• I understand my girl AND I must follow the Girl Scout Law and Booth Etiquette Rules, otherwise she could potentially lose her rewards and may be prevented from participating in the remainder of this year's Girl Scout Cookie Program.
• I agree that Girl Scouts of Historic Georgia can email me directly at the provided email address, regarding my daughter's participation in the 202-202 Product Programs, even though I may have opted-out of receiving GSHG emails when we registered.

The provision of Social Security number, Driver's License and Date of Birth are necessary due to the financial responsibility inherent in participating in the Girl Scout Cookie Program. This information will be kept in strict confidence and only used if necessary for debt collection. All entries will be destroyed after total payments are made to the council office. Should you decide not to provide your Social Security Number, Driver's License number and date of birth your daughter may still participate in the Cookie Program by prepaying for cookies or by working cookie booths with the troop leaders.

I give permission for my Girl Scout to participate in Girl Scouts of Historic Georgia's 2026 Fall Product Program and/or 2027 Cookie Program. By signing below, I verify that I have read and acknowledged the above statements. I confirm that the above information is true and accurate.

It is the procedure of Girl Scouts of Historic Georgia ('GSHG') to work with all Service Units to resolve outstanding debt to the troop and/or council. If a delinquent payment is anticipated, this should be communicated to the Service Unit Cookie Program Manager before the payment is made by the troop to avoid money being withdrawn via Automated Clearing House (ACH) and a penalty incurred for insufficient funds. The following are guidelines established to settle outstanding debt.

1. The Troop Leader/Service Unit Cookie Program Manager (SUCPM) and/or Service Unit Manager (SUM) must notify GSHG of uncollected funds for the first ACH pull via email (to Director of Product Program and/or Product Program Manager) per the date specified in the 2027 Cookie Program Volunteer Guide.
The following support documentation must be provided:

• Delinquent Account form
• Copies of all receipts for cookies/payments
• A copy of the signed Caregiver Permission form
• Caregiver Debt Procedure form
• Any correspondence(s) (emails, texts, etc.)

2. Upon receipt of documentation GSHG will adjust the troop balance due to reflect the unpaid caregiver's portion.

3. Once notification has been received, GSHG will contact the caregiver.
a. First (1st) notice: Caregiver will be contacted by phone as well as by email informing them that they have ten (10) business days to pay amount due in full.*
b. Second (2nd) notice: After ten (10) business days, a second letter will be sent to the caregiver stating they have fifteen (10) business days in which to respond with their payment in full.* A copy of the letter will be sent to the SUM/SUCPM and Troop Leader.
c. All efforts will be made to offer the caregiver payment options. * No additional cookies will be swapped or checked out by the caregiver until the delinquent amount is paid to the Product Program Manager. Once paid, caregivers requesting more cookies must pay for any remaining inventory before additional cookie orders are filled.
d. The caregiver is responsible for obtaining a receipt for any cookies picked up and any payments made. The caregiver should not take cookies or submit money without a receipt.
e. Third (3rd) notice: A certified letter will be sent to the parent if no response has been received after ten (10) business days following the second (2nd) notice. GSHG will continue to offer the caregiver payment options.*
f. Final Notice: A final letter will be issued if there is still no response following the third (3rd) notice, and thirty (30) business days of attempted debt resolution. The parent will be informed that GSHG is filing "Theft by Taking" or "Theft by Conversion" charges against them with the appropriate court of law.

4. Girl(s) will not receive rewards/incentives for any sales until outstanding debt to GSHG is paid in full. Debt paid after Product Program Credits expire will result in credits being forfeited.

5. Adults/girls who have any outstanding debt owed to GSHG are not permitted to participate in the council product program or other fundraising activities until such debt is resolved.

6. Any adult who has an outstanding debt owed to GSHG is not a certified member in good standing of GSHG and, therefore, may not officially represent GSHG in the community, council, or beyond. In addition, she/he cannot handle troop, community, or GSHG funds or products.

*Payments will be accepted via certified check, money order, credit/debit cards or cash.

Electronic signatures shall have the same force and effect as a wet signature and shall be accepted as assent and agreement to the foregoing contract.