Extended Troop Trip Application

*Please review the Troop Management Guide for details regarding trip requirements, readiness, training, planning, Certificates of Insurance (COIs), High Risk and Prohibited Girl Scout Activities, required forms, and emergency procedures prior to submission of this application.

Submission of this Extended Troop Trip Application is required by Girl Scouts of Eastern Pennsylvania (GSEP). Within 10 (ten) business days of submission, trip details are reviewed and the submitter is notified of approval or remediation steps needed for approval. Without approval from GSEP, your trip will not be considered an official Girl Scouts trip.

Submission Deadlines:

Trips 3+ nights within Council footprint—30 days prior to trip
Trips 3+ nights outside Council & within U.S.—60 days prior to trip
International trips—3 months prior to trip

Today's Date 0/0

Troop Number 0/0

Service Unit Number 0/0

Service Unit Name 0/0

Trip Leader Name 0/0

Trip Leader's Phone Number 0/0

Trip Leader's Email Address 0/0

Number of Brownies attending trip If 'zero' enter 0 0/0

Number of Juniors attending trip If 'zero' enter 0 0/0

Number of Cadettes attending trip If 'zero' enter 0 0/0

Number of Seniors attending trip If 'zero' enter 0 0/0

Number of Ambassadors attending trip If 'zero' enter 0 0/0

Number of Adult Females attending trip 0/0

Number of Adult Males attending trip If 'zero' enter 0 0/0

Emergency Contact not on trip 0/0

Emergency Contact attending the trip 0/0

Name of First Aid & CPR Certified Volunteer attending the trip 0/0

Name of Overnight Skills Trained (IOS/BOS) Volunteer attending the trip 0/0

List other certifications, including certification type, certified volunteers name, and dates of certifications below 0/0

Departure Date 0/0

Return Date 0/0

Trip Destination 0/0

Will the troop be doing any high risk activities while on the trip?

Yes

A Certificate of Insurance (COI) is required for all high risk activities. Please refer to the list on page 8 in the GSEP Troop Trip Guide.

Lodging Name & Address 0/0

Transportation type 0/0

Airline & Flight Numbers 0/0

Airfare cost 0/0

Lodging cost 0/0

Transportation cost 0/0

Food cost 0/0

Activities cost 0/0

Tipping cost 0/0

Tip buffer cost 0/0

Insurance cost 0/0

Other costs 0/0

Total trip cost 0/0

Statement of Compliance

GSUSA and GSEP health, safety, and emergency procedures have been reviewed and are being followed.
Parents/caregivers have been informed of the trip activities and safety and emergency procedures, as well as provided with essential contact information.
Appropriate permissions, including the Girl Health History & Release Form and Permission for Troop Activity, have been obtained for each Girl Scout and will be in the possession of the Trip Leader and First-Aider at all times during the trip.\
This trip was an option for all current troop members.
At least 50% of the Girl Scouts in our troop will participate.
We will conduct ourselves in a positive manner and understand that we are representing Girl Scouts.
In accordance with GSUSA health and safety guidelines, all adult trip participants can perform their volunteer responsibilities.
My Service Unit Manager has been notified via email of our intent to travel.

Compliance Agreement By entering my name I am agreeing to all compliance statements above. 0/0

Attach Adult Attendees List

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