Girl Scout Weekend Registration Form
Troop Information
Troop Number
*
Program Option Choice
*
Farm Track (Farm Program, High Ropes, Ring Ride/ Horse Care, Garden Program)
Nature Track (Nature Program, Canoeing, Climbing Wall, Archery/ Tie Dye)
Troop Leader Name
*
First Name
Last Name
Troop Leader Contact Number
*
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Troop Leader Email Address
*
example@example.com
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Troop Leader Information
Adult Trip Leader 1
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Dietary Restrictions
Adult Trip Leader 2
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Dietary Restrictions
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Scout Information
Scout 1
First Name
Last Name
Dietary Restrictions
Scout 2
First Name
Last Name
Dietary Restrictions
Scout 3
First Name
Last Name
Dietary Restrictions
Scout 4
First Name
Last Name
Dietary Restrictions
Scout 5
First Name
Last Name
Dietary Restrictions
Scout 6
First Name
Last Name
Dietary Restrictions
Scout 7
First Name
Last Name
Dietary Restrictions
Scout 8
First Name
Last Name
Dietary Restrictions
Additional Scouts?
Please provide additional Scout information
Submit
Should be Empty: