CONTACT INFORMATION

Primary Contact / Leader (Full Name Required)

Troop / Den

Address Line 1

Address Line 2

City

State

Zip

Your Email (required)

Phone

ATTENDING GROUP SIZE (Please specify all who will attend)

Number of Adults:   1 2 3 4

Number of Scouts:   1 2 3 4 5 6 7 8 9 10

Participating Siblings:   0 1 2 3 4 5 6 7 8 9 10

Number of Non-Participating Siblings:   0 1 2 3 4 5 6 7 8 9 10

Girl Scout Programs

Daisy Scout Badges (Select one, if applicable)

Art Maker (seasonal)   Be A Sister to Every Scout   Board Game Challenge   Courageous and Strong   Eco Learner (seasonal)   Good Neighbor

Brownie Scout Badges (Select one, if applicable)

Art Creator (seasonal)   Celebrating Community   Letter Boxer   Making Games   My Family Story Painting (seasonal)

Junior Scout Badges (Select one, if applicable)

Art Explorer (seasonal)   Detective   Playing in the Past   Social Butterfly  

Cub Scout Programs

Tiger Scout Badges (Select one, if applicable)

Family Stories   Stories in Shapes   Tiger Tales   Tiger-iffic  

Bear Scout Badges (Select one, if applicable)

Beat of the Drum   Forensics   Marble Madness  

Wolf Scout Badges (Select one, if applicable)

Adventures in Coins   Code of the Wolf   Collections and Hobbies   Finding Your Way (seasonal)  

Webelo Scout Badges (Select, if applicable)

Art Explosion  

Comments (additional info, etc.)

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