BFC Afterschool-Armory Program 2025-2026 Membership Form

GSNNJ Girl Membership Form 2025-2026

BFC Afterschool Program -44 Armory
Check One:
Girl Name

First NameLast Name
Birthday
(mm/dd/yyyy)
Grade in School
School Name
Girl's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Custodial Care:
If not both parents, then who is the custodial parent
She is (check all that apply):

Other
Girl is Hispanic or Latina:
Caregiver Name

First NameLast Name
Caregiver address if different from Girl's:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Caregiver Birthday
(mm/dd/yyyy)
I am the Primary Caregiver/Contact (as listed above)
Caregiver Gender:
Caregiver Race (check all that apply):

Other
Caregiver is Hispanic or Latina:
By opting in for emails and text alerts, you agree to receive important information concerning membership, programs, cancellations, and closures as applicable. Understanding such content is not required to join. I wish to opt in for:
Caregiver E-mail
example@example.com
Caregiver Mobile/Cell Number
Format: (000) 000-0000.
To meet the requirements to receive program funding, all information on this form must be disclosed.
In order to accommodate girls of all abilities, please indicate if your child has any disabilities as defined by the Americans with Disabilities Act:
If yes, what accommodations does your child need:
Single Parent Household:
Household Income FY2024:
Number of persons in family:
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 substitue wording appropriate to their own spiritual beliefs for the word "God".)

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.
I accept and abide by the Girl Scout Promise and Law:
When participating in Girl Scout activities, I (or the person I am registering) give consent to be interviewed, photographed, videotaped, or electronically imaged for purposes of promotional materials, news releases, or other published formats for either the local Girl Scout Council 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. I accept the Media Permission:
Caregiver/Contact Signature and CC Authorization. This signature serves as permission for the registrant to join Girl Scouts.

Clear
Signature Date

MonthDayYear
Date
Should be Empty:

GSNNJ Girl Membership Form 2025-2026