2015 Cookie Program Parent/Guardian Permission and

Girl Scouts of Central California South
www.girlscoutsccs.org  Phone: (800) 490-8653  Fax: (559) 291-5079
Headquarters: 1377 W. Shaw Ave., Fresno, CA 93711
Regional Office: 230 NW 3rd Ave., Visalia, CA 93291
Regional Office: 1831 Brundage Lane, Bakersfield, CA 93304
2015 Cookie Program
Parent/Guardian Permission and Responsibility Form
My Girl Scout ___________________________________, a registered member of Troop #_____ ___,
has my permission to participate in the 2015 Girl Scout Cookie Program. In doing so, I agree to accept financial responsibility for all
products ordered and money she receives, and therefore I agree to submit full payment to her Troop Cookie Chair by stated
deadlines. I understand that in failure to pay for products accepted by my Girl Scout(s), Girl Scouts of Central California South may
take collection action against me. The collection action will seek any delinquent unpaid balances from me, and require that all
related cost(s) be paid. I understand that the courts of Fresno County, CA will have jurisdiction for the purposes of collection.
By signing below, I agree that:
• I will ensure that my daughter is a registered Girl Scout for the 2014-2015 Girl Scout year.
• I will ensure that my daughter has adult supervision during the sale at all times.
• I will ensure that my daughter or members of her family will not begin taking orders or selling cookies before Sunday, February 1,
2015 or boothing before Friday, February 20, 2015. I understand my Girl Scout will forfeit all of the recognitions she might have
earned if this occurs.
• I understand the proceeds earned from the Cookie Sale belong to the Troop and not to my Girl Scout.
• I understand that the Troop Cookie Chair will give me a signed receipt for all products I receive and all money I turn in, and that it
is my responsibility to keep copies for one year.
• I understand that product may not be returned or exchanged, and any unsold product is my responsibility.
 I understand that Girl Scouts of the USA regulates the sale of product on the internet. Girls and troops cannot collect monies
through the internet EXCEPT through Vendor Partner websites as directed in the Troop Guide and Family Guide.
• I understand all monies are due for cookies no later than March 22, 2015.
• I understand that my Girl Scout will not receive recognitions or Cookie Dollars if monies have not been turned in to the troop
and/or Council by March 22, 2015.
• I understand that Troop proceeds are non-transferrable between troops.
• I understand that if my Girl Scout sells 500+ packages of cookies, she will qualify to attend the 500 Club Event, and will have
options for date and location. I understand that if my Girl Scout qualifies and cannot attend on any of those dates, she will not
receive a ticket for another day. I have read and understand the information on the 500 Club Event in the 2015 Cookie Program
Family Guide.
• I understand that if my Girl Scout sells 750+ packages of cookies, she will qualify to attend the Cali Girl Adventure Event as detailed
in the 2015 Cookie Program Family guide. I understand that if my Girl Scout qualifies and cannot attend on that date, she will not
receive a ticket for another day. I understand that only required adult chaperones will attend the event. I have read and
understand the information on the Cali Girl Trip in the 2015 Cookie Program Family Guide.
• I understand if my Girl Scout sells 1000+ packages of cookies, she will qualify to attend the SSSSH Girl (Super Seller Secret Society
Honors, 1000+ packages) Trip as detailed in the 2015 Cookie Program Family Guide. I understand that only required adult
chaperones will attend the trip. I have read and understand the information on the SSSSH Girl Trip in the 2015 Cookie Program
Family Guide.
Name of Parent/Guardian:
Address:
Preferred Phone Number:
Signature:
Email:
City:
Zip:
Alternate Phone Number:
Date:
RECOGNITION CHOICE (Please circle choice)
250+ Packages: Small Plush Polar Bear OR Cross Body Bag
SIZE CHOICE (Please indicate size)
400+ Packages: T-Shirt Size:
(YS) (YM) (YL) (AS) (AM) (AL) (AXL) (AXXL) (AXXXL)
650+ Packages: Hoodie Size:
(YS) (YM) (YL) (AS) (AM) (AL) (AXL) (AXXL) (AXXXL)
P:\2012 Product Program\COOKIE SALE PROGRAMS\2015 Cookie Sale\2015 Cookie Forms\2015 Cookie Program Parent Permission Slip.doc