Event Registration Form

Event Registration Form Mail or fax this form, or register online at www.gswcf.org. All applicable fees must accompany this form. Forms without payment will be returned. Questions? Call the customer service manager: 800-881-4475. Individual Registration (not attending with a troop) Girl’s Name Address/City/Zip Code County______________________ Phone # (day) E-mail Confirmation will be sent via e-mail. Troop # (evening) Troop Level __________________________ Troop Registration Troop Contact Name Address/City/Zip Code County______________________ Phone # (day) E-mail Confirmation will be sent via e-mail. Troop # (evening) Troop Level __________________________ Programs, Events (List names of participants below) # of Girls # of Adults Date Time Fee Adults are limited to Safety-Wise ratios. Event Fee Membership Fee Family Partnership Total Enclosed Card# $___________ $___________ $___________ $___________ $___________ # girls x fee # adults x fee Add $10 for each nonmember Voluntary Donation Check (payable to Girl Scouts of West Central Florida) Exp. Date 3-digit ID Signature Adults Attending Visa, MasterCard, Discover, American Express Girl Participants Girl Participants Special dietary or medical needs: Registration closes 3 weeks prior to the event, or when the event fills. Send this form and payment to: Girl Scouts of West Central Florida • ATTN: Customer Service Manager P.O. Box 18066 • Tampa, FL 33679-8066 Fax: (813) 262-1794 Register Online: www.gswcf.org

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