Girl Membership

Type of Membership *

Girl Information

Date of Birth:

Parent/Legal Guardian Information

Custodial Information *
Date of Birth for guardian:
I wish to opt in
Date of Birth for guardian:
I wish to opt in


Girl Scouts respects and welcomes people from all backgrounds and abilities. By completing the following information (as defined by the U.S. Census Bureau), you ensure support and funding for girls in your community. Hispanic/Latina is defined as an ethnicity, not a race, therefore is reported separately. This information is used for statistical purposes only.
She is *
She is Hispanic or Latina *

Membership Fee

The membership fee for Girl Scouts is $25
(good until September 30, 2021)
Financial Aid Needed *

Family Partners

YES! I would like to make a Family Partnership donation today that directly benefits girls in our area. Enclosed is my tax-deductible donation in the amount of: (check one)


The Girl Scout Law
I will do my best to be
honest and fair,
friendly and helpful,
considerate and caring,
courageous and strong, and
responsible for what I say and do,
and to
respect myself and others,
respect authority,
use resources wisely,
make the world a better place, and
be a sister to every Girl Scout.

The Girl Scout Promise
On my honor, I will try:
To serve God and my country,
To help people at all times,
And to live by the Girl Scout Law.
When making the Girl Scout
Promise, individual members
may substitute wording appropriate to their own spiritual
beliefs for the word “God.”

Media Permission
When participating in Girl Scout activities, I (or the person I am registering) give consent to be interviewed, photographed, videotaped, or electronically imaged for the purposes of promotional materials, news releases, or other published formats for either the local Girl Scout councils or Girl Scouts of the USA. The images will be the sole property of the local Girl Scout council or Girl Scouts of the USA.  I hereby release and hold harmless the local
Girl Scout council and Girl Scouts of the USA from any claim arising from the use of these images
 Fees are not refundable or transferable to another person.


*By signing here and checking the circles above, each signee (and on behalf of the girl, as applicable) agrees to receive auto-dialed informational or marketing text messages at the cell number above, understanding such
consent is not required to join.

I am not a robot