Hemlock Girl Scout Council Individual Program Registration Form
Complete form and mail to Hemlock Girl Scout Council, PO Box 2837, Harrisburg PA 17105-2837
Program Name ______________________ Program Date _____________________
Troop Number 1966 Service Unit E-7 Grade 8
Girl's Name ________________________ Parent's Name ____________________
Address ___________________________ Telephone (day) ___________________
City/Zip ___________________________ Telephone (evening) ________________
E-mail Address ________________________________________________________

Parent/Guardian must read and sign:

Enclosed is $ ________________ for my daughter/ward to attend the program named above. I understand it is my responsibility to transport her to and from the event.

Signed _________________________________________ Date ___________________