Girl Scout “Trees” Badge Workshop Registration

Parent or Guardian Name *

First

Last

Please note: we ask that every party has at least one adult chaperone. Adult chaperones are responsible for their children at all times. No drop-offs, please.

Parent or Guardian Contact Information

Address Line 1

Address Line 2

City

State

Zip Code

Mailing addresses are OPTIONAL and will only be used for statistical purposes to help the C&O Canal Trust to apply for grant funding to help make future programs possible.

Email *

Phone *

Only used in the event of an emergency

First and last name of participating Girl Scouts

Please note, the activities are intended for Cadette Girl Scouts, grades 6-8. Older/younger scouts, friends and siblings are welcome to attend, but Cadettes will have first priority in registration.

Name *

First

Last

Total number of participants in your party (scouts, friends, adult chaperones etc.) *

Are there any allergies or medical conditions we should be aware of?

Does anyone in your party need special accommodations? (Mobility, sensory, etc.)

MEDIA RELEASE FORM: By checking the box below, I hereby consent and agree that the C&O Canal Trust, its employees, contractors, and/or agents have the right to take photographs and/or digital recording, and other images of me and/or the minor(s) under my supervision, and to use or exhibit them, or license them for use or exhibit by others in any and all media, now or hereafter known, for the purpose of furthering the mission of the C&O Canal Trust. I further consent that my name and identity and the name and identity of the minor(s) under my supervision may be revealed therein or by descriptive text or commentary. I do hereby release to the C&O Canal Trust, its agents, contractors and employees all rights to exhibit this work in print and/or electronic form, publicly or privately, and to market and sell copies. I waive any rights, claims, or interest I may have to control or to approve the use of my identity or likeness and/or those of the minor(s) under my supervision in whatever media used. I understand that there will be no financial compensation or other remuneration for recording me and/or the minor(s) under my supervision, either for initial or subsequent transmission or playback. I represent that I am at least 18 years of age, have read and understand the foregoing statement, and am competent to execute this agreement. I further represent that I have the authority to grant the foregoing release on behalf of the minors identified below. *

I agree
I DO NOT agree

Comments, Questions and Anything else we should know?

Connect with the C&O! Be the first to know about C&O news, projects, and events through our monthly e-newsletter, the Canal Connection! * Yes, I want to subscribe to the monthly e-newsletter. *

Yes, I want to subscribe to the monthly e-newsletter
No, I do not want to subscribe at this time.

Would you like to make a donation to the C&O Canal Trust to support future programs? We suggest $10 per participating child.

Photo credit: Jim Blair

Girl Scout “Trees” Badge Workshop Registration

First and last name of participating Girl Scouts

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