Parent or Guardian Permission for Participation in Girl Scout Activities Group / Troop ’ s Volunteer Name _______________________________________ Group / Troop # __ __ __ __ __
Group / Troop ’ s Volunteer Phone Number ______________________________ Cell _____________________
My daughter has permission to participate in the Girl Scout activity listed below . I will make sure she does not attend if she is not feeling well .
Activity Date Place Cost
1 . Parent / Guardian Signature ________________________________________ Date ______________________ 2 . Parent / Guardian Signature ________________________________________ Date ______________________ 3 . Parent / Guardian Signature ________________________________________ Date ______________________ 4 . Parent / Guardian Signature ________________________________________ Date ______________________ 5 . Parent / Guardian Signature ________________________________________ Date ______________________ 6 . Parent / Guardian Signature ________________________________________ Date ______________________ 7 . Parent / Guardian Signature ________________________________________ Date ______________________ 8 . Parent / Guardian Signature ________________________________________ Date ______________________ 9 . Parent / Guardian Signature ________________________________________ Date ______________________ 10 .
Parent / Guardian Signature ________________________________________ Date ______________________ Parent / Guardian Emergency Phone Number ______________________________________________________ Emergency Contact _____________________________________________ Phone ______________________
Revised 10 / 15 / 12
12