Meeting Location: __________________________
Date and Time: _____________________________
This acknowledgement is to be completed for each troop, county/area/service unit, and council activity by
everyone in attendance (both girls and adults) as it also serves as a roster for your in-person gathering.
Your signature on this sheet indicates that the participant has met the pre-screening guidelines outlined in the
Family Agreement and Pre-Screening Document.
Participant Name
Parent/
Guardian Name
(if applicable)
Signature
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For troops, leaders will retain a copy of this document for their records, for county/area/service unit activities the
meeting organizer will retain a copy for their records and for council activities GSNCCP will retain a copy for their
records.