Girl Scouts Of Middle Tennessee Girl Registration Form
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1
2Girl Registration
Join the global network of 2.5 million Girl Scouts
New Member
Returning Member
Personal Information
Contact Information
Address
Troop
Service Unit
Registration Area
Address Line 1
Registration Year through 9/30/
Address Line 2
Girl First Name
Girl Middle Name
City
Girl Last Name
State
Zip Code
Parent/Guardian (1) First Name
Parent/Guardian (1) Last Name
Email
Relationship to Girl
Mother
Father
Guardian
Preferred Email
Parent/Guardian (2) First Name
Phone
Parent/Guardian (2) Last Name
Home Phone
Relationship to Girl
Mother
Father
Guardian
Mobile Phone
Demographics, Participation and Acceptance
Acceptance
Demographics
Media Permission
Note: Girl Scouts respect and welcome people from all backgrounds and abilities. By
completing the following information (as defined by the US Census), you ensure support and
When participating in Girl Scout activities (I or the person I am
funding for girls in your community. Hispanic/Latino is defined as an ethnicity, not a race,
registering) give consent to be interviewed, photographed, videotaped,
therefore is reported separately. This information is used for statistical purposes only:
or electronically imaged for the purposes of promotional materials,
news releases, or other published formats for either the local Girl Scout
T-Shirt Size
Youth Small
Youth Medium
Youth Large
Council or Girl Scouts of the USA. The images will be the sole property
Adult Small
Adult Medium
Adult Large
of the local Girl Scout Council or GSUSA. I hereby release and hold
Adult XL
Adult XXL
Adult XXXL
harmless the local Girl Scout Council and GSUSA from any claim arising
Adult XXXXL
Adult XXXXXL
from the use of these images.
Choose Not to Share
I wish to opt out at this time:
Yes
No
Number of years as a Girl Scout
Date of Birth
The Girl Scout Promise
On my honor, I will try: To serve God and my country,
School
To help people at all times, And to live by the Girl Scout Law.
Grade (K-12)
When making the GS Promise, individual members may substitute
wording appropriate to their own spiritual beliefs for the word “God.”
Custodial Care
Both
Mother
Father
Other
Unknown
The Girl Scout Law
I will do my best to be honest and fair, friendly and helpful,
Race
American Indian
Asian
Black
Hawaiian
White
considerate and caring, courageous and strong, and responsible
Multiple
Other
Choose Not to Share
for what I say and do, and to respect myself and others, respect
authority, use resources wisely, make the world a better place,
Ethnicity
Hispanic
Not Hispanic
Choose Not to Share
and be a sister to every Girl Scout.
Participation
I / We acknowledge that the registrant will accept and
abide by the Girl Scout Promise and Law. The registrant has
I will be participating in Girl Scouting as: (check all that apply)
permission to join Girl Scouts.
Camp - Connect with nature. Choose a camp by day or overnight.
Troop - Have fun on a regular basis with your Girl Scout sisters.
Events - Focus on half or full day events to share your passions.
Note: You must agree to the Girl Scout Law to proceed with membership.
Travel - Pack your bags. Travel across town or around the world!
Horses - Curious about horses? Experience how to care for horses,
riding or improving your horsemanship skills.
Signature
Date
| (615) 383-0490
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