Girl Scout Council Sponsored Product Program
2020 Cookie Program
Parent/Guardian Permission Form
Please read and complete the information below and return the form to your troop leader for every registered
Girl Scout who participates in the council product programs. Troop leader retains the form for their troop records.
GIRL SCOUT’S INFORMATION (please PRINT all information)
First Name: Last Name:
Troop # Service Unit: County:
Grade Level: ❑ Daisy ❑ Brownie ❑ Junior ❑ Cadette ❑ Senior ❑ Ambassador ❑ Juliette
Parent/Guardian First Name MI Last Name
•
•
Home Mailing Address Apt #
City State Zip Code
Area Code Phone (Home) Area Code Phone (Cell)
Employer Area Code Work Phone
Business Address
City State Zip Code
New York State Driver’s License Number Parent/Guardian E-mail Address
Girl Scouts of Western New York, Buffalo Service Center, 3332 Walden Ave., Suite 106, Depew, NY 14043
Form #320.99.PPF Revised 07.2019
2020 GIRL SCOUT COOKIE PROGRAM
My Girl Scout has my permission to participate in the Girl Scout cookie program.
I agree to accept full responsibility for all product and money received for the cookie program.
I agree to pay the cookie bill in full and on time to the troop leader/volunteer. It is understood and
agreed that in the event any outstanding balance has to be referred to a collection agency or attorney
for recovery, I will be fully responsible for all collection agency fees and attorney’s fees.
I understand the income from the product programs does not become the property of individual girl
members. Girls, however, may be eligible for incentives and credits that may be applied toward
Council sponsored camps, programs, uniforms, and membership.
I have reviewed the Girl Scout Internet Safety Pledge, Product Sale-Safety Activity Checkpoints, and
Safety Tips for Product Sales (visit gswny.org and select forms).
Girl Scout Law says, “I will do my best to be honest and fair.” I agree that my Girl Scout will not sell
prior to the first day of the Girl Scout cookie program and I will provide adult supervision for her during
the sale.
___________________________________________________________ ________________
Signature of Parent/Guardian Date
