GSNETX Membership 2020

2020-2021 Membership Registration Form

Due to a system update, our membership registration through your personal login is not currently available. By completing this form, you are submitting registration and can begin participating in Girl Scout activities, however, you will not receive final membership confirmation until our system comes back up and we're able to process your registration fully in December. Please note that GSNETX Offices are closed for the Thanksgiving holiday beginning Saturday, November 21, and reopening on Monday, November 30. If you need assistance, please reach out to customercare@gsnetx.org.

Please submit one form per member you are registering today.

Who are you registering for Girl Scouts today?*

A girl An adult

Are you a new member or returning/renewing member?

New Member Returning/Renewing Member

Do you know a specific Girl Scout troop that you would like to join?

No Yes

Please provide the troop number or any other information you know about the troop.

Girl Member's Registration Information

Girl's Name*

First Name

Last Name

Grade for 2020-2021 school year*

Girl's School*

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Girl's County of Residence*

Girl's Date of Birth*

Custodial Care Information*

Girl Scouts respects and welcomes people from all backgrounds and abilities. By completing the following information (as defined by the U.S. Census Bureau), you ensure support and funding for girls in your community. Hispanic/Latina is defined as an ethnicity, not a race, therefore is reported separately. This information is used for statistical purpose only and will be kept confidential. GSNETX never sells or shares member information with third parties.

Girl Race*

Am. Indian or Alaskan Native Asian Black or African American Hawaiian or Pacific Island Other Races White I choose not to share.

Check all that apply.

Girl Ethnicity*

Primary Parent/Caregiver Information

Primary Caregiver's Name*

First Name

Last Name

Primary Caregiver Email*

Confirm Primary Caregiver Email *

Primary Caregiver's Phone*

Is the primary caregiver's address the same as the girl's?*

Yes, it's the same address. No it's a different address.

Primary Parent/Caregiver Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Primary Parent/Caregiver's County of Residence*

Girl Scouts respects and welcomes people from all backgrounds and abilities. By completing the following information (as defined by the U.S. Census Bureau), you ensure support and funding for girls in your community. Hispanic/Latina is defined as an ethnicity, not a race, therefore is reported separately. This information is used for statistical purpose only and will be kept confidential. GSNETX never sells or shares member information with third parties.

Caregiver Race*

Am. Indian or Alaskan Native Asian Black or African American Hawaiian or Pacific Island Other Races White I choose not to share.

Check all that apply.

Caregiver Ethnicity*

Family Household Income*

Secondary Parent/Caregiver Information

Secondary Caregiver's Name*

First Name

Last Name

Secondary Caregiver Email*

Confirm Secondary Caregiver Email *

Secondary Caregiver's Phone*

Is the secondary caregiver's address the same as the girl's?*

Yes, it's the same address. No it's a different address.

Secondary Parent/Caregiver Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Secondary Caregiver's County of Residence*

Girl Scouts respects and welcomes people from all backgrounds and abilities. By completing the following information (as defined by the U.S. Census Bureau), you ensure support and funding for girls in your community. Hispanic/Latina is defined as an ethnicity, not a race, therefore is reported separately. This information is used for statistical purpose only and will be kept confidential. GSNETX never sells or shares member information with third parties.

Caregiver Race*

Am. Indian or Alaskan Native Asian Black or African American Hawaiian or Pacific Island Other Races White I choose not to share.

Check all that apply.

Secondary Caregiver Ethnicity*

Adult Member's Registration Information

Adult's Name*

First Name

Last Name

Adult's Email*

Confirm Adult's Email *

Adult's Phone*

Adult's Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Adult's County of Residence*

Adult's Date of Birth*

Would you like to sign up to volunteer today?

No thank you Lead a Girl Scout troop Act as the Troop Cookie Manager for a troop Help support a Girl Scout troop Find out about other ways to volunteer

Girl Scouts respects and welcomes people from all backgrounds and abilities. By completing the following information (as defined by the U.S. Census Bureau), you ensure support and funding for girls in your community. Hispanic/Latina is defined as an ethnicity, not a race, therefore is reported separately. This information is used for statistical purpose only and will be kept confidential. GSNETX never sells or shares member information with third parties.

Adult's Race*

Am. Indian or Alaskan Native Asian Black or African American Hawaiian or Pacific Island Other Races White I choose not to share.

Check all that apply.

Adult's Ethnicity*

Family Household Income*

Membership Registration Acceptance for Household

All members must agree to follow the Girl Scout Promise & Law and accept the GSNETX Terms and Conditions.

Girl Scout Promise & Law / Terms & Conditions*

I / we accept and will abide by the Girl Scout Promise and Law and the updated Terms and Conditions.

Media Release

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.

Email Opt In

Girl Scouts reserves the right to send transactional or service-related emails. I would also like to receive Girl Scouts promotional email.

Text Opt In

I would like to receive informational or marketing text messages (some of which may be autodialed), as well as autodialed/prerecorded calls from the Girl Scouts at the mobile number provided above. I understand that I am not required to agree to receive these text messages and calls to create an online profile.

$25 Annual National Membership Fee

The annual membership for Girl Scouts of the USA is $25. Financial assistance is available upon request.

Do you need financial assistance for this membership?

No Yes

Cardholder's Name*

First Name

Last Name

Cardholder's Email*

Cardholder's Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Credit Card Information*

$25* $

Number of memberships