Custodial parent/guardian name
Phone-Day (
)
Second parent/guardian name
Phone-Day (
)
Evening (
)
Evening (
)
In case of an emergency when parent/guardian is not available, please notify:
Name
Phone-Day (
Relationship
)
Evening (
)
GIRL CODE OF CONDUCT
I WILL cooperate with the adult in charge, respect the people and places with which I come in contact,
abide by the Girl Scout Promise and Law, participate in all required activities, be responsible for my
personal belongings and equipment, and observe all safety regulations. I understand that if I am
involved in any unacceptable behavior, I may be sent home. I understand that if I am sent home, it will
be my parents/guardians responsibility to pick me up any time of the day or night and that any additional
expense incurred will be their responsibility.
Participant’s signature
Date
Parent/guardian signature
Date
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