Trip Planning Summary
form #119a • 10/21 • page 2 of 2
Trip Budget Check-in: See Troop/Group Trip Planning Guide for more detailed budget worksheet
Troop/Group Funds Contributed:
Expected Cost per Girl:
Family/Girl Contribution:
Expected Cost per Adult:
By signing below, I verify that the information provided on this form is true to the best of my knowledge.
Troop Leader Signature:
Date (mm/dd/yy):
For TC use only Approved: Not Approved:
Travel Coordinator Name:
Travel Coordinator Signature:
Date (mm/dd/yy):
Travel Coordinator Notes
Type of trip:
Day trip with a high-risk activity (check to see which Approved Outfitter they are using)
Indoor Overnights – no outdoor cooking, sleeping inside or with access to indoor bathroom, kitchen
Cabin Camping/Outdoor Overnights – cooking outside/with fire, no access to indoor bathrooms, kitchen
Backpacking/primitive camping
Trip leader must initial each line below:
We agree to follow GSOSW In-Person Troop/Group Meeting Guidelines, Safety Activity Checkpoints and GSOSW policies
and procedures, federal and state laws.
Adult attendees who work with girls and/or are counted towards girl-to-adult ratio must have: current membership, a
completed background check, GSOSW Foundations online training, and GSOSW Mandatory Reporter online training.
All participants/guardians have been informed of the travel plans including, but not limited to:
• departure and arrival times
• all destinations and activities
• emergency contact information
• type of transportation
The established emergency contact (an adult not attending the trip/high adventure activity) has a copy of the itinerary,
roster, carpool list and health forms of who is attending. This person understands they are responsible for knowing the
whereabouts of the group at all times.
A signed permission form for each girl, from each girl’s parent/guardian, is in trip leader’s possession at all times. All
participants (girls and adults) have provided the trip leader with an up-to-date health history form. A copy of each girl’s
signed permission form, with health history, is given to each driver and emergency contact.
Leader will ensure that licensed, responsible adult drivers (21 years or older) are familiar with council policies and
emergency procedures.
Any men in attendance have separate sleeping quarters and bathrooms.
Leader has consulted the Troop/Group Trip Planning Guide throughout girl-planning process.
At least one adult has required trainings (i.e. Day Trips, Indoor Overnights, Outdoor Skills, First Aid/CPR, etc.)
We agree to not make any purchases or reservations toward the trip before receiving approval of this form 119a.
Troop has a record of a cancellation date/policy set for travel plans. Troop understands if they do not have a cancellation
policy and / or they do not honor the policy stipulations they run the risk of losing funds payed toward the trip if trip must
be cancelled due to unforeseen circumstances.
All funds raised for travel by members of GSOSW troops are, and shall be continue to be, owned by GSOSW for the benefit
of the specific troop’s use as approved by GSOSW. In no event shall funds raised or donated to an individual volunteer or
troop member through GSOSW-affiliated activities, or items purchased with such funds, be considered to be owned by
that individual, volunteer or troop member.
