CC Guiders

Forms: Registration

(photocopy page 2 to the back of page 1)

Girl’s Name:_________________________________ Age:_________ 

Birth date:____________________ month  /  day /   year

Address:__________________________________________ Postal  Code:_____________

Phone:_______________                                                                                   E mail:_____________________

Parents or _______________________________Occupations____________          wk phone___________

Guardian’s Names_________________________                  ____________            wk phone___________

GIRL’S BACKGROUND

Girl’s School ________________________________________Grade:__________

Previous years in Guiding:  Sparks: ____ Brownie: _____Guide_____   Date first enrolled___________

Unit Name:____________________________ Name and Address previous Guider __________________

____________________________________________________________________________________

How many siblings in family?__________________ ages:__________________

Other family interests:__________________________________________________________________

 Does your daughter belong to other groups? _______________________________________________

 ANY LEARNING AND/OR PHYSICAL DIFFICULTIES that may help the Guider when she is preparing

 the program work, etc.(please use a separate paper if more explanation is needed) _______________ ____________________________________________________________________________________

*******There is a lot involved in our weekly meetings.  Your daughter’s leaders are parents like 

you who volunteer their time and need assistance behind the scenes.  We invite you to offer 

your talents and interests to help us develop the Guiding program to the fullest.  Please signify 

the areas where your will assist us.

full time helper____ part time helper____  special occasion  helper____ phoning committee_______

Driving:______  number of seat belts_______   special occasion refreshments________       

 Camping Helper_______ Hiking Helper______ Games_________ Music__________ 

Nature Studies________1st Aid/medical__________________ Sports _________________________

 Handicrafts or hobbies [signify] _________________________________________________________

Registration Fee: $42.00    [payable at registration] Cash_______ Cheque_______  *

Please complete the other side of form re: earthquake preparedness form and generic permission form.

 Date of Registration:_______________ Parent/Guardian Signature:_____________________________

Note: * If payment is a hardship to you please let us know. Monetary assistance is available.

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REGISTRATION RECEIPT North District GIRL GUIDES OF CANADA

Girl’s Name:_______________________________ Unit Name:_______________________________

$42.00 Paid by   cheque_______ cash________    Meeting Place:____________________________

                                [cheque payable to unit name ]   Meeting Day: _________________Time_________

PAGE 2

Leaders’ Signature_________________________1st Meeting:_______________________________

Leader’s Phone:___________________________

                                                            PERMISSION FORM

I give permission for my daughter ___________________________to be taken by her unit leaders on short outings during regular meeting times.  These outings will be within walking distance of the regular meeting place.  Any other outings will require a permission slip and a note explaining the type of outing, and transportation required.

parent / guardian signature________________________________date___________________________

Should the opportunity arise, I give permission for my daughter to be included in photographs and/or videos which may be used for Girl Guide publications, media coverage or promotional activities for Girl Guides of Canada, and that her name may be used.

parent / guardian signature________________________________date__________________________

_________________________________________________________________________________

EARTHQUAKE OR OTHER DISASTER PREPAREDNESS:

We do not know when an earthquake or other local disaster may strike in B.C. but we can be prepared.  We realize that such an emergency may occur when your daughter is at a meeting or even at camp.  In an effort to be prepared for such an occurrence, emergency supplies and procedures are available to our Guiders who may be responsible for the girls on site for several hours or even days until contact can be made with you.  Be assured that every effort will be made for the safety and comfort of the girls.

EARTHQUAKE out of province contact for emergencies. Please do not use the same names of your local contact people.

Please fill in both copies below. The top is for the Guiding leaders. Duplicate this information on the bottom half and keep for your reference.

Girl’s Name:__________________________________

Name and Address of out of town relative or friend who can provide contact /communication for separated family members.

Name:_________________________________________Relationship________________________

Address:_______________________________________ Phone #::__________________________

_____________________________________________________________________________________

OUT OF PROVINCE EMERGENCY CONTACT (Duplicate the above information and keep this for your record. Your registration receipt is on the back of this for your record)

NAME:______________________________________Relationship________________________

Address:_____________________________________ Phone #________________