Girl Scout at the LoneStar Indoor Sports Center (Cookie Rally Lock-in) and Public Skate night Registration

Form $20 is enclosed for Skating and Cookie Rally. Check can be made payable to GS SU416. Troop # : __________ SU#________ Age Level: DSY BR JR CAD SR Leader’s Name: _______________________ Phone Number: _____________________________ Email address: __________________________________________________________ Please list all girls and registered adults who will be attending: (Attach separate sheet if needed) Girls & Skate size (if skating) Girls & Skate size (if skating)

Adults Skate size (if skating)

Total number of Skaters #_____ x $5 Total number for Cookie Rally _____ x $15 Family Skaters ____ x $5 Total number S/W for your Troop Skaters #_____ x $5 Checks made to GS SU416 Check #_____ TOTAL

= $______ = $______ = $______ = $______ = $_____

The following information is requested for United Way reporting (total number participants): # kids American Indian/Alaskan Native Asian Black or African American Also Hispanic Registration and payment must be received by December 17, 2011 (late fee if any openings) No registration refunds. Send Program Registration Form and Fee to: Lindsey Lambert Girl Scouts of Northeast Texas 2317 W. University Dr. Suite 167 Denton, TX 76201 Phone 940-243-1314 Maximum of 299 skaters S/W allowed for the sleepover! #adults Hawaiian/Pacific Islander White Other # kids #adults

***** One form per Troop / Girl Scout ***** Does your child have any food Allergies?? ** Menu ** pizza, a light before bed. a quick breakfast before pick up at 8am.

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