Girl Scouts in the Western Communities

Girl Scouts of the Western Communities: (GSWC)
Wellington, Royal Palm Beach, Loxahatchee & the Acreage

Please Note that this form can ONLY be used for events scheduled in our service area. IF you are attending an event scheduled through council's GS Program Brochure ( http://www.gssef.org/calendar/online-program-brochure.aspx), you MUST use their forms. Thank you!

Hello Leaders,

Below is an explanation of how to use the e-Registration form for events offered through the GSWC web site.
I have added some information and added other sections that will now allow for e mail confirmation of your registration and it will also allow for council (Sue Holmes) to approve your travel application which is required any time you take your scouts anywhere outside of a regularly scheduled troop meeting.
For your troop's individual travel applications that are not to a Large Event scheduled through Girl Scouts of the Western Communities, please use your regular Travel Application found on the Girl Scout disk you received or on the forms page on the GSPGC website.

HOW TO USE THE e-REGISTRATION FORM:

Below please find the Event/Activity Registration form for programs scheduled in the Western Communities. This form can be used in a couple ways.

IF the event is FREE. Just cut and paste the email into a new email, fill out the form and email it to Ocean Friedman, cfocean32@yahoo.com or the Event Chair.

If the event has fees associated with it, you can send the form via email to reserve a spot for your troop and mail a check to Ocean or the Event Chair by the registration deadline. Your check must be received by the registration deadline or your registration cannot be guaranteed.

OR, you can print the page, fill out the form and mail it along with your check to Ocean or the Event Chair to reserve a space(s) for the event.

You may also register and/or make payments at any Western Communities Service Unit Meeting (second Wednesday night of every month at RPBHS in the Media Center) prior to the registration deadline.

By sending in your registrations early we will be better able to plan if we know how many troops/girls will be attending... By sending in your check by the registration deadline we will be able to purchase needed supplies for the event. We have had a team of leaders working diligently over the Summer break to bring the girls some great programs this year. Please continue to check the website for events scheduled in our area.

------------------------------------cut and paste information below into an email--------------------------------------------

Western Communities Event Registration Form Today’s Date: ______ Registration Deadline: ________

Fee for participants: $________ x number of participants _______ = $____ Total due

Payment Method:      _______ Check (Payable to GSWC)                    ________ cash

**Sorry no refunds unless event is canceled.



Mail form with payment to (unless otherwise stated):

Carolyn “Ocean” Friedman
110 Galiano Street
Royal Palm Beach, FL 33411
Phone: 561-310-6514

Email: cfocean32@yahoo.com



*Note: This form can be filled out and sent via email to Ocean and /or the event chair to reserve your troops' registration. If the event is a FREE event no further action is needed. Upon receipt of your registration, you will receive an email confirmation.

               If there are fees associated with the event, you must mail a check to Ocean Friedman and / or the event chair by the registration deadline or your troops' registration cannot be guaranteed. If the event has limited space and payment is not made by the registration deadline and other arrangements have not been made, troops on a "waiting list" will be used to fill the event.

**Hurricane Policy:
When the National Weather Service issues a Hurricane Watch or Warning for any portion of the council jurisdiction, during the time period for which a Girl Scout activity is scheduled, the event will automatically be postponed. After the weather emergency has passed, you will be contacted regarding the reschedule or cancellation.

Event / Activity Name: _______________

Event Date: ______________ Event Time: _________

Event Location: ___________________

Troop/Group No: _____ Service Unit: ____ Program Level: ________

Leader / Advisor Name (or participant if individual girl): _____________

Email Address (important for confirmation): ________

Address: __________ City: _________

Zip Code: _________________

Phone No: Day: _____________ Eve: _______

-----------------------------------------------------------------------------------------------------------------------------------------
For Individually Registering Girls (only):
(we can pair your daughter with a troop)

I, (parent) _________________________ give my permission for the child to attend the above stated event / activity.

My child _______________________ is in good health and is able to participate in the activity.

_____I plan on staying at the event and will participate with my child.

_____My child will be participating in this event with

Girl Scout Troop_____ and Leader/Advisor: ______________

This leader's phone number is: _________________________

If parent does not attend:

Person to contact in case of emergency: __________________

Phone Number: _____________________________________

------------------------------------------------------------------------------------------------------------------

Form of Transportation (i.e. van, cars, train, etc) _______________________

Leader/Advisor’s electronic Signature _____________ Date _______

Roster of all participants including girls, adults, and tag-a-longs. Participants not registered with GSUSA may require additional Girl Scout insurance coverage. (Please consult event chair for further information on who can attend.)

Roster of Girls Attending:

Additional Adults Participating:

______________________ Phone ________________ Email ___________

CPR / 1st Aider: Name: _________ Certification Expires ___________

At Home Contact _____________ Phone ______________ Email ____________________

Troop Camper (if applicable) __________ Phone ______________ Email ____________

Lifeguard (if applicable) ______________ Phone ______________ Email ___________

Name of Course Completed _________ Certification Expires ______________________

Water Watcher (if applicable) __________ Phone ______________ Email ___________

Tent Pitcher (if applicable) _____________ Phone ______________ Email ___________

* Fees:

Confirmation Notice:

Date: ________ Event Chair: _____________

You Are Confirmed for this event: ______

Sorry, the event is full, if there are any cancellations, we will be in touch: ____

Travel Application Approval Information: Council Use Only

Your request for approval of (activity) __________________ is: q approved q not approved (see reverse for reasons.)

Approved By: ____________________________________ _______________________

Service Unit / Program Manager Date

____________________________________ _______________________

Service Manager Date

Based on the information provided:

q Application complete—Have a great time!

q First Aid / CPR Required

q At Home Contact Required

q A record of health examination (physical checkup) may be required for each participant. See Safety Wise Standard 3.

q Helmets required for activity.

q Adult in charge must verify that the activity provider has shown evidence of current liability.

q Other ____________________________________________________

Girl Scouts of the Western Communities 7/09

Girl Scouts in the Western Communities

Members of the Girl Scouts of Southeast Florida, Inc.