Girl Scouts of River Bluffs Council

#4 Ginger Creek Parkway - Glen Carbon, IL 62034

(618) 692-0692  -  (800) 345-6858 - Fax (618) 692-0685

estanley@riverbluffs.org

Courage, Confidence, Character.....Courage, Confidence, Character.....Courage, Confidence, Character.....Courage, Confidence, Character

The OAR Program

Troop Registration Form

Please print off and mail with appropriate fee to: GSRBC, OAR, 4 Ginger Creek Parkway, Glen Carbon, IL 62034

 

Leader/Advisor Name________________________________________________________________

Address___________________________________________________________________________

City______________________________________________State__________Zip________________

Phone (D)_____________________________________(E)__________________________________

E-Mail_____________________________________________Troop #_______ Service Unit________

Number of participants by program level:

• Daisy_____ • Brownie_____ • Junior_____ • 11-17_____ • Adults_____ (if participating, same price as girls)

Activities:

1. _______________________   3. ___________________

2. _______________________   4. ___________________

Date Requested_____________________Time__________Alternate Date___________________ Time_______

 

PAYMENT OPTIONS:

1st Activity:                          # Participants_______ X $_______per participant = $__________

2nd Activity:                         # Participants_______ X $_______per participant = $__________

3rd Activity:                          # Participants_______ X $_______per participant = $__________

Outdoor Passport Patches     # Girls          _______ X $1.50 = $_______X $________Activity = $__________

TOTAL AMOUNT DUE:  $______________

 

Check Enclosed      Mastercard      Visa      Discover

Card #_____________________________________________ Expiration Date_________

Authorized Cardholder’s Signature ____________________________________________ Date___________

 

Refunds will only be given if cancellation is made THREE WEEKS prior to session. If sessions are cancelled because of inclement weather, vouchers for the same session will be issued for use on another date.

This page last modified on April 03, 2007.

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