Girl Scout Weekend Registration Form

Girl Scout Weekend Registration Form
Troop Information
Troop Number *
Program Option Choice *

Nature Track (Nature Program, Canoeing, Climbing Wall, Archery/ Tie Dye) Farm Track (Farm Program, High Ropes, Ring Ride/ Horse Care, Garden Program)
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	Country

Troop Leader Email Address *
example@example.com

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

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
Should be Empty:

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