CAMPSITE DEPARTURE REPORT FORM
This form must be completed in order to process your security deposit refund.
For all troops/groups/service units and non-Girl Scout groups, complete and return this form immediately
upon completion of your camping event.
For troops/groups meeting regularly at a campsite, complete and return this form at the end of your
reservation period.
Return this form to: GSWPA, 5681 Route 6N, Edinboro, PA 16412
CAMP USED
Unit or building
Dates in camp: Arrival date
Group Leader’s Name
Departure date
Phone
Address
Street
County
City
State
Zip
Email Address
Would you or a member of your group be interested in being a member of an outdoor property or program team?
Yes, outdoor property team Yes, program team
No thank you
GIRL SCOUT MEMBERS: Troop #
# Daisy
# Brownie
# Junior
# Total Girls
# Adults
NON-GIRL SCOUT GROUPS: # Girls
Service Unit # and Name
# Cadette
# Senior
# Ambassador
# Boys
Total #
# Adults
Incidents, accidents or injuries:
Please describe.
Did you complete a service project while at camp?
If so, please describe.
What type of activities did you participate in while at this site?
Check all applicable activities or describe.
Hiking
Outdoor Cooking
Nature Exploration
Other (please describe)
Did you travel off-site to local attractions?
Yes
Water (swimming or boating)
No
Which attraction(s)
To ensure better camping experiences at our properties, please number the following as they apply.
(1) Satisfactory
(2) Unsatisfactory
Check-in/Safety review with Ranger
Cleanliness of buildings used
Cleanliness of restrooms
Fireplace/Fire circle
Kitchen equipment
Program equipment
Hiking trails
Confirmation materials
Further comments:
(Over) You MUST complete the Campsite Cleaning Checklist
194