6901 Pinecrest Road
Raleigh, NC 27613
Community Partner Agreement
Organizations may partner with Girl Scouts North Carolina Pines in different ways. Be sure to read through the
entire Community Partner Information Packet before filling out this agreement. Discount Partners are not
required to complete the Community Partner Agreement, as Girl Scouts North Carolina Coastal Pines
does not sponsor these activities. Please complete on your computer, save a copy and email to the
appropriate Program Team member or the Program Executive. Electronic initials and signatures are accepted.
The relationship between Girl Scouts North Carolina Coastal Pines and Community Partners is a voluntary
partnership and can be dissolved at any time for non-compliance with our safety and risk management
standards, insurance requirements, and actions that do not align with the mission and values of Girl Scouts.
Community Partner Agreements are valid from October 1
through September 30
An organization is considered a partner with Girl Scouts North Carolina Coastal Pines when the
agreement is initialed/signed and the insurance requirements (list on page 5) are fulfilled.
All activities must be staffed by the community partner’s staff or volunteers. Girl Scouts North Carolina
Coastal Pines cannot offer staff assistance during activities. We do however reserve the right to attend
for observation purposes.
Section 1: Community Partner Organization Overview
Name of partner organization:
Address Line 1:
Address Line 2:
City: State: Zip:
Organization Website:
Main phone number:
Email Address:
Name of contact person:
Job title of contact person:
Has the organization been a partner with Girl Scouts North Carolina Coastal Pines in the past? Yes No
Please provide a brief description of the partner organization:
Community Partner Option (check all that apply)
Girl Scout Leadership Experience Partner for Badges or Journeys
Just for Fun Patch or Fun Outing Partner
Section 2: Acknowledgement of Girl Scout Policies and Procedures
Please read and initial each item to verify that your organization understands these requirements and will
diligently work to adhere to these standards.
__________ The partner organization supports Girl Scouts in its efforts to make Girl Scouting available to all
girls and adults, regardless of race, ethnicity, religion, age, national origin, gender, veteran
status, sexual orientation, marital status, or the presence of any physical, sensory, or mental
disability (provided that the participant can safely undertake the activity).
__________ The partner acknowledges that Girl Scouts may not raise or solicit money for other
organizations, may not participate in walkathons or telethons, and may not participate directly or
indirectly in any political campaigns.
__________ The partner acknowledges that Girl Scouts North Carolina Coastal Pines will not give out
personal contact information or email addresses of its members and that if the council receives
complaints regarding the use of personal contact information and email addresses, the
partnership will not continue.
_________ Organizations that partner with Girl Scouts North Carolina Coastal Pines must submit a current
certificate of insurance verifying that the organization has a reasonable amount of general
liability coverage for the activities the activity will include.
__________ The partner will comply with all applicable safety guidelines including those stated in the partner
information packet’s insurance and safety requirements section. Read and follow applicable
Safety Activity Checkpoints.
__________ The partner will refrain from sharing the Girl Scouts program materials with any other parties or
organizations and only use it to train and prepare your staff to provide the program
__________ Partner organizations understand that all permission forms and waivers must be signed by a
parent/guardian if the participant is under 18 years of age.
___________ The partner understands that Girl Scouts North Carolina Coastal Pines cannot guarantee event
___________ The partner has read and will follow the expectations articulated in the partner information
packet on these topics:
Cancellation Policy
Girl Scout Brand
Activity Survey
__________ The relationship between Girl Scouts North Carolina Coastal Pines and each Community
Partner organization is voluntary and can be dissolved at any time.
_______________________________________ ____________________________________
Community Partner Printed Contact Name Signature Date
Email the completed Community Partnership Agreement and proof of insurance to the Program Executive or
appropriate Program Team member.
If you have any questions, please reach out to:
Laura Lee Davis
Program Executive
click to sign
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