Council Activity Registration - Girl Scouts Of Central Texas
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1Council Activity Registration
REGISTRATIONS MAY BE SUBMITTED UP UNTIL THE LAST REGISTRATION DATE INDICATED IN EBIZ. Registrations will be accepted after
this date only with permission from the Program Staff.
TROOP LEADER/GUARDIAN COMPLETING REGISTRATION
_________________________
___________________________
Troop #
Phone
Home
(
)
_______________________________________________
___________________________
Name
Cell
(
)
_______________________________________________
___________________________
Address
Work
(
)
_______________________________________________
City, Zip
Program Level
GS Daisy
GS Brownie
GS Junior
_______________________________________________
Email
GS Cadette
GS Senior
GS Ambassador
ACTIVITY & PARTICIPANT INFORMATION
Registration for all Activities is now open and will close on the date shown in eBiz. If an Activity is full, that will be indicated in eBiz. If there is a
Wait List, you may still register. Payment is required to be put on the Wait List. The Activity Fee will be refunded if you are not placed.
Activity Name
______________________________________________
Participation Information/Registration Fees
Date of Activity
______________________________________________
Activity Location ______________________________________________
Fee (Per Person)
Total
Number of Participants
PAYMENT MUST ACCOM
Y THIS FORM.
PAN
Girls awarded Financial
Registered Girls
_______ $_____________ $_____________
Partnership must attach the certificate to this form. Being granted Financial
Adults
_______ $_____________ $_____________
Partnership does not guarantee placement in this Activity.
TOTAL
$_____________
METHOD OF PAYMENT
Check
Credit Card Number_______________________________________________ Exp. Date ______________
Cash
Signature________________________________________________________
Financial Partnership
Amount Granted
_________________________________________
$
Girl Scout Dough# __________________________________________ Amount of Dough to Be Applied
_______________
: $
Payment will be cashed/charg ed upon receipt of this form.
PARTICIPANT INFORMATION
Attach your troop roster or complete the following information for each person (Girls and Adults) attending the Activity.
PARTICIPANT’S NAME
CURRENT GRADE/ADULT
EMERGENCY CONTACT NAME AND PHONE NUMBER
___________________________________________________________________________
_________
_______________________________________________________________________
___________________________________________________________________________
_________
_______________________________________________________________________
___________________________________________________________________________
_________
_______________________________________________________________________
___________________________________________________________________________
_________
_______________________________________________________________________
___________________________________________________________________________
_________
_______________________________________________________________________
___________________________________________________________________________
_________
_______________________________________________________________________
___________________________________________________________________________
_________
_______________________________________________________________________
___________________________________________________________________________
_________
_______________________________________________________________________
___________________________________________________________________________
_________
_______________________________________________________________________
___________________________________________________________________________
_________
_______________________________________________________________________
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