GIRL SCOUTS OF THE PHILIPPINES

Baguio Girl Scout Council

GIRL SCOUT ACTIVITY PARENTAL CONSENT FORM/WAIVER

COUNCIL: BAGUIO REGION: NORTHERN LUZON

___________________ ____________________ _______________ ______________ ____

LAST NAME FIRST NAME MIDDLE NAME CIVIL STATUS SEX

HOME ADDRESS:______________________________________________________________________________
CONTACT NUMBER:__________________________________________________________________________
BIRTH DATE: _________________________________________________________________________________
SCHOOL & ADDRESS: _________________________________________________________________________
MESSENGER & EMAIL ADDRESS: _______________________________________________________________
AGE LEVEL (EX. TWINKLER, STAR, JUNIOR, SENIOR, CADET): ___________________________________
VOLUNTARY ACTIVITY REGISTRATION AMOUNT: ₱ 65.00

PARENT'S/GUARDIAN'S CONSENT
To whom it may concern:

This is to allow my/our daughter, _________________________________________ born last

(Last Name, Given Name, Middle Name)
_____________________, with _________ of age, studying at ________________________________
(Date of Birth) (age) (name of school)

to register as a member of the GIRL SCOUT OF THE PHILIPPINES – BAGUIO CITY COUNCIL this year 2022-
2023 AS ____________
(Age Level)

We have considered the benefits that our daughter will derive from her participation this event with the
understanding that every precaution is to be undertaken to ensure her safety in camp. We shall not hold the Staff
responsible for any untoward accident that may happen beyond their control.

__________________________________________ ______________________
Signature over printed name of Parent or Guardian Date Signed

__________________________________________
Contact Number of Parent or Guardian

ACKNOWLEDGEMENT RECEIPT
(Council Copy)

Amount: _________________ Date Received: _________________

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ACKNOWLEDGEMENT RECEIPT

Amount: _________________ Date Received: _________________