2026-2027 Product Program Family Agreement Form
To participate in Girl Scouts in the Heart of Pennsylvania's Product Programs, including the Fall Product and Cookie Programs, a parent or caregiver must complete this agreement. Only one form is required per membership year. Order cards and other program materials will be distributed after the completed form has been received by the Troop Leader. Girls are not eligible to participate in Product Programs until the completed agreement has been submitted to GSHPA.
Girl Scout Name
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First Name
Last Name
Troop #
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Parent/Caregiver #1
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First Name
Last Name
Relationship to Girl Scout
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Parent/Caregiver #2
First Name
Last Name
Relationship to Girl Scout
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Primary Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Caregiver Email
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example@example.com
Troop Leader Email: Please ensure this is the troop leader email address as a copy of your agreement will be emailed to your troop leader.
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example@example.com
Do you owe any current debt or are on a payment plan with GSHPA for previous product program sales?
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Yes
No
My Girl Scout has my permission to participate in the 2026-2027 Girl Scouts in the Heart of Pennsylvania (GSHPA) Product Programs (Fall Product and/or Cookies). By allowing my Girl Scout to participate, my Girl Scout and I agree to:
Ensure my Girl Scout is registered for the 2026-2027 Girl Scout Membership year;
Ensure my words and actions abide by the Girl Scout Promise and Girl Scout Law at all times;
Maintain a valid email address for all program communications and approved GSUSA online selling platforms;
Ensure my Girl Scout is participating in Product Programs in accordance with all GSHPA Product Program guidelines (dates, locations, prices, etc.);
Ensure my Girl Scout is selling products at the designated price point and agree not to alter prices;
Ensure my Girl Scout has adult supervision and guidance at all times while participating in the Product Programs;
Pick up product and rewards from my troop volunteer at the time, date, and location designated by my troop;
Ensure that all Fall Product and/or Cookie orders are delivered to customers within one (1) week of receipt. Failure to do so can result in future participation restrictions;
Ensure all payments for products are submitted to the troop by the deadlines established by the troop volunteers.
By entering my name below, I understand that only a Girl Scout registered for the 2026-2027 Girl Scout year is permitted to sell Girl Scout products. I understand that products cannot be returned to Girl Scouts in the Heart of Pennsylvania for any reason. I understand and agree that if I do not pay for the products ordered and accepted by my Girl Scout, Girl Scouts in the Heart of Pennsylvania may take collection action against me. I will be responsible for any and all costs incurred, including attorney fees, court costs, and interest.
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Please verify that you are human
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Submit
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