Program Event Registration Form
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1
2Program Event Registration
Troop Registration or
Individual Registration
Initial Registration or
Add-On Registration
Event Name _________________________________________________________________________________________
Event Date ______________________Location:____________________________________________________________
Troop/Group #__________________ Troop Leader Name: ______________________________________________________ (if applicable)
Age Level: ________ Daisy ________ Brownie ________ Junior
________ Cadette ________ Senior _________ Ambassador
# of girls in each age level
Troop Contact Person for Event: _________________________________________________________________________________________
Who should receive event confirmation and information
E-mail Address ________________________________________________________________________________________________________
Program event information will be e-mailed to this address above
Address _______________________________________________________________________________________________________________
City, State___________________________________________________________________________ Zip_______________________________
Daytime Phone _________________________________________ Evening Phone ________________________________________________
Cell Phone ____________________________________________________________________________________________________________
Registration Summary
# of girl(s) attending _________x $_____________ = $________________
# of adult(s) attending _______ x $_____________ = $________________
TOTAL EVENT FEE $ ________________
T-Shirt Order – See event description for availability of T-Shirts. T-Shirts are not available for every event.
Youth: S_____ M_____ L_____ Adult: S_____ M_____ L_____ XL_____ XXL_____
List quantity needed for each size
Total # of Shirts____________@_____ = TOTAL T-SHIRT ORDER $______________ (if applicable)
Payment:
Cash
Check (made payable to GSGMS)
Credit Card: Account # ______________________________
MC
VISA
Expiration Date __________________ Security Code _________
Payment must accompany the registration form. Checks or money orders should be made payable to GSGMS. Registration
forms will not be processed without payment.
Registration Procedures:
Registrations may be mailed or hand delivered to GSGMS. They will be stamped with date and time received in office. Registrations will be
processed if all information is COMPLETE and PAYMENT is received in full. Registration closes when event is full or on event deadline,
which ever comes first. In the event an event does not reach capacity, the event will remain open at the discretion of the program unit. A
waiting list will be maintained for all events that have reached capacity.
Refunds and Cancellations:
Girl Scouts of Greater Mississippi reserves the right to cancel or reschedule an event for lack of registrants, inclement weather or situa-
tions beyond the council’s control, and only those registered will be notified. If an event is cancelled and event registrations have already
been accepted, the program department will notify the troop’s contact person and process refunds.
If a participant chooses to cancel their registration for an event, written notice of cancellation must be received by GSGMS no less than
10 business days prior to the event date in order to receive a refund. There will be no refunds for events costing less than $5. There will be
a cancellation fee of $5 on all events costing more than $5. No refunds are given for failing to attend the event.
For Trips and Travel Programs : Initial deposits for all trips and travel programs are non-refundable. Written cancellation for trips or
travel programs must be received no less than 90 days prior to departure. No fees will be refunded within 90 day of departure.
Be sure that Safety-Wise girl-adult ratio standards are met when registering for events.
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