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Troop/Service Unit Activity Application

A Troop Activity Application is needed for each activity held beyond the troop meeting place with approval at the council Service Unit level. This clearance is necessary to ensure that this activity is consistent with Girl Scout Policies and Standards. Girl Scout insurance is in effect only for approved activities. This form must be filled out and approved at least two weeks prior to event.

If you prefer to download a form for fax or mail delivery, see our Forms Library.

Instructions:

Fill out only those parts applicable to the activity which your troop has planned. Required fields are marked with a star *
Troops planning to go camping should fill out the "Overnight/Camping" section. If activity involves a council-operated site, complete a Campsite Reservation Form and submit to Troop Camp Registrar.
For trips outside Massachusetts (except to Patriots' Trail camps), you must also submit your itinerary, address, and phone numbers. Make sure that all contracts reach the Council Boston Office one month prior to your trip to obtain the approval and signature of the Chief Operating Officer.
For trips exceeding three nights, please check with your local office for extended troop trip application to be completed six months prior to extended trip.
Review Safety-Wise before completing the form. (Safety-Wise is not available online. However, you may review the Girl Scouts, Patriots' Trail Council Policies and Standards Related to Troop Activities (clicking here will open the policies in a new window.)

This online form is processed by staff in the service center. When you press the "Send" button, a summary of your responses will appear. You should print this summary for your records.

If you have questions about the Troop Activity Application, Troop Activity Policies, Required Certifications, or any other matters, call the membership services team in our Waltham office, 781-893-6113. For technical support of this online form, contact the webmaster in our Boston office, 617-482-1078.

Troop Information

*Service Unit
*Troop Number(s) (OR enter SU for Service Unit Event)
*Program Level

Leader Information

*Name of person submitting form
*Email of person submitting form

*Troop Leader's Name
*Leader's Day Phone
Leader's Eve Phone
Leader's Email
*Leader's Street Address
*Town/City
*State *ZIP Code

Activity Details (complete for all activities)

*Type of Activity: Day Trip Overnight/Camping Money Earning

Safety-Wise Checkpoints

*Reviewed Universal Checkpoints (pages 81-83) No Yes
*Reviewed Activity Checkpoints (pages 78, 94, 112) No Yes (indicate pages reviewed: )
*Reviewed Specific Activity Checkpoint No Yes (indicate pages reviewed: )

*Date of event
*Destination

*Program Description:

*Participants: # of girls # of women # of men

*Mode of transportation:
Leader/Adult Vehicle Individual Transportation
Chartered Bus (see "Chartering Buses") Public Transportation
Leased/Rented Vehicle Other: (describe)

CPR/First Aider (see Safety-Wise checkpoints)
First Aid/CPR Name
First Aid/CPR Phone
First Aid Date of Expiration
CPR Date of Expiration
-OR- Current Licensed Health Care Professional

*Is additional accident insurance (Mutual of Omaha) required? No Yes (Contact council staff) IMPORTANT: additional insurance is required for all non-Girl Scout participants.

Additional Comments:

Additional Safety Requirements (if applicable)

Certified Troop Camper (see GSPTC Leaders Manual page 16):
Name
Phone
Date certification expires

Additional Certified Adult(s) (See Safety-Wise Checkpoints)
Certified Adult Name
Certified Adult Phone
Type of Certification
Date Certification Expires

Certified Adult Name
Certified Adult Phone
Type of Certification
Date Certification Expires

Overnight and Camping

Arrival Date Arrival Time
Departure Date Departure Time

Has your Troop Camper checked local fire regulations and confirmed the contact information for the local police and fire department and nearest hospital? Yes No

Emergency on-site phone/cell number:

Money Earning

Type of Money Earning Activity:

How much do you plan to raise?

For what purpose:

Did you participate or plan to participate in the last Council Cookie Sale? Yes No

If no, why not? (See GSPTC Leaders Manual, page 8, column 1, paragraph 2)