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Little Brownie Bakers
Parent/Guardian Permission and Responsibility Form
When you complete this form, you are granting permission for your Girl Scout to participate in the Girl Scouts of Northeast Texas, Inc.'s ("GSNETX") 2019-2020 Fall Product Program and/or the 2019-2020 Cookie Program. You understand and agree to follow all policies and guidelines associated with these programs as listed below and in the program Family Guides.
In order to avoid delays in your Girl Scout's participation, be sure to enter your Girl Scout's name and troop number as it is listed in your
My GS account
. Need help? Check out this
step by step tutorial
.
Questions with a red asterisk must be completed in order to complete the application.
Parent/Guardian Information
*
Parent First Name
*
Parent Last Name
*
Home Address
*
City
*
Zip Code
*
Email
*
Phone
Your Girl Scout's Information
*
Girl First Name
*
Girl Last Name
*
School Name
*
Grade Level
Select Grade --
K
1
2
3
4
5
6
7
8
9
10
11
12
*
Date of Birth
*
Shirt Size
Select size --
Youth small
Youth medium
Youth large
Adult small
Adult medium
Adult large
Adult XL
Adult 2X
Adult 3X
Adult 4X
Your Girl Scout's Troop Information
*
Troop Number
*
Service Unit
numbers only
*
Troop Leader Email
*
TCM Email
Additional Information and Options
Media Release
(Optional)
more info...
I give GSNETX, Girl Scouts of the USA, and the United Way the rights and permission, without any compensation, to take, use, reuse, publish, and republish photographs, pictures, media, video recordings, interviews, and other images of my Girl Scout, without restriction, and her name in any published matter for publicity, news releases, social media campaigns, and/or for any public relations purposes. I waive any right that I or my Girl Scout may have to inspect or approve any finished product or products or the advertising copy or printed matter that may be used in connection with such photographs, pictures, media, video recordings, interviews, images, or the use to which they may be applied. I hereby release and hold harmless GSNETX, Girl Scouts of the USA, and the United Way from any claim arising from the use of such images.
Rewards Waiver for Additional Cookie Proceeds Only
(6th - 12th Graders ONLY)
more info...
I confirm that my Girl Scout is in 6th – 12th grade (Cadette, Senior or Ambassador) and has voted to accept an additional $0.10 per package of cookies sold in lieu of reward items. Girl Scouts in grades K – 5th grade are not eligible to opt out of rewards for additional proceeds.
Consent to Receive Emails and Texts
(Optional)
more info...
I agree to receive, for myself or on behalf of my Girl Scout, auto-dialed information, marketing text messages or emails, and other transactional service-related messages to the email address(es) and/or phone number(s) listed above, understanding such consent is not required to join Girl Scouts.
Acknowledgement of and Agreement to Terms
Program Terms and Conditions
By electronically submitting this form, I agree to abide by each of the following statements:
I will ensure that My Girl Scout's membership remains current and active.
I accept
full
financial responsibility, including on-time payment, for all Girl Scouts product(s) ordered (including, but not limited to, cookies) and money due related to my Girl Scout’s participation in all Girl Scout programs.
I agree that product(s) ordered by my Girl Scout which is not sold or remains unused may not be returned to GSNETX.
My Girl Scout will not receive rewards if her balance for the any Girl Scout program is not paid in full and on time.
I agree that all past due balances on any product(s) ordered may be referred to a collection agency and I will be responsible for paying costs and fees associated with all collection efforts.
I agree that taking orders and selling prior to the official start dates of the programs below is strictly prohibited:
Fall Product Program: September 6, 2019
Cookie Program: January 17, 2020
I agree that posts on social media sites and platforms supporting my Girl Scout may only be shared on private accounts (friends and family only). Posts on public pages or groups of any kind are not allowed.
I agree that product(s) may only be sold for the prices set by GSNETX. I agree that I will not set separate prices for any product(s). Additionally, I agree that credit card fees will not be passed along to the customer.
I will follow
booth sales processes and etiquette
at approved booth sales and understand failure to follow process and etiquette, including not approaching council partners, will result in a $25 fine per instance applied to the girl/family and/or troop who violates the policy
I, the undersigned parent and/or legal guardian of the above-mentioned Girl Scout, do hereby acknowledge and agree that I have read, understand and agree to all terms and conditions herein and on this site.
*
Full Name
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