Annual Permission Form

This form grants overall permission for your Girl Scout to attend and participate in troop and council-sponsored activities that are:

Located within one hour’s driving time of the regular meeting place
Held on a virtual platform
Not exceeding 6 hours
Not considered high risk activities as outlined in Safety Activity Checkpoints

Prior to any trip or program outside of the normal meeting place and time, your troop leader should provide you with information, including:

Itinerary
Costs
Transportation Arrangements
Names and Contact Info for Chaperones
Necessary Clothing or Equipment

In addition to the Annual Permission Form, you should also complete an annual Health History and Consent to Administer Medical Treatment Form and the Internet Safety Pledge for virtual activities.

Girl Scouts, Hornets' Nest Council recognizes that the ongoing COVID-19 pandemic presents challenges and the health and safety of girls and volunteers is always our top priority. Participation in all Girl Scout activities is voluntary and families should make decisions about the inherent risks associated with in-person activities for their girls. Caregivers and troop leaders should review and follow current GSUSA and GSHNC guidelines for all in-person and virtual activities.

If you have questions or concerns about a specific activity, please contact GSHNC Customer Care at customercare@hngirlscouts.org or 704-731-6500.

A copy of this form will automatically be emailed to your troop leader, please ensure you have entered the correct email address. This form can also be printed and submitted to your troop leader if you prefer.

This form is valid for the Girl Scout Membership Year beginning October 1st*

Year

Girl's Name*

First NameLast Name

Girl's School*

Grade*

Date of Birth*

Date

Parent/Guardian Name*

First NameLast Name

Parent/Guardian Email*

Cell Phone Number*

Area CodePhone Number

OK to text?*

YesNo

Address*

Street Address

Street Address 2

CityState

Zip Code

Troop Number*

Troop Leader Name*

First NameLast Name

Troop Leader Email*

example@example.com

Emergency Contact Name*

First NameLast Name

Emergency Contact Phone*

Area CodePhone Number

Emergency Contact Relationship to Girl*

Check all that apply:*

My Girl Scout has permission to attend activities within 1 hour driving time of the meeting place and not exceeding 6 hours in duration.My Girl Scout has permission to attend all activities, except those considered high-risk* or involving an overnight stay.*High-risk activities and overnight/extended trips require an individual Overnight Parent Permission form.(Troop Leaders are required to submit a Troop Trip Application to GSHNC for trips involving high-risk activities, cruises, or international travel).I have completed and submitted an annual Health History and Consent to Administer Medical Treatment form to my troop leader.I know of no reason(s) why my Girl Scout may not participate in prescribed activities, with or without special accommodations, except as noted on her Health History form.

Please list any dietary, medical, special needs or accommodations needed (leave blank if none).

I have read and understand this Annual Permission Form. I will notify the troop/group leader of any changes in emergency contact information. I may change or revoke any aspect of this agreement at any time by submitting my request in writing to the troop/group leader.*

I agree

Parent/Guardian Signature

Annual Permission Form

Contact Information

Permission