Cookie Program Girl Scout Permission Slip

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Click "Embrace Possibility" for the 2025 Girl Scout Cookie Program Permission Slip!
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2024 Girl Scout Cookie Program

Girl Scout's of Ohio's Heartland Permission Slip and Caregiver Responsibility Form
By checking each box below, I agree that:*
Girl Scout Name*

First NameLast Name
Troop Number*
Caregiver Name*

First NameLast Name
Caregiver Email*
youremail@email.com
Caregiver Phone Number*
Please enter a valid phone number.
Caregiver Address*

Street Address

Street Address Line 2

CityState

Zip Code
Troop Cookie Program Coordinator Email*
example@example.com
By signing this document, I understand and accept all terms outlined above and acknowledge my financial responsibility and personal liability for all products and money associated with my Girl Scout’s participation in the 2024 Girl Scouts of Ohio’s Heartland Cookie Program.*

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Individual Reward Choices
Girl Scouts participating in the 2024 Girl Scout Cookie Program earn rewards based on their total packages achieved by the end of the program on March 17.
- Troop cookie program coordinators will distribute rewards to Girl Scouts when they arrive in April.
- Due to availability, a comparable item may be substituted for any reward item.
Rewards Options

Beginning at the 245+ level, Girl Scouts can choose to receive a physical reward item, donate to The Shoe That Grows, or receive a GSOH reward card.
- Choose The Shoe That Grows to help us reach our council goal of donating 250 pairs of shoes that expand five sizes for children to wear for school, chores, or play in the harsh conditions in refugee camps. Girl Scouts participating in this philanthropic reward opportunity will receive a special Shoe That Grows patch.
- Reward Cards can be used towards GSOH programs, shops, camp, site usage, Girl Scout Destinations, or GSOH approved travel. Girl Scouts receive one card with the total amount they earned after the cookie program ends.
200 Packages*
245+ Packages *
300+ Packages *
400+ Packages *
500+ Packages *
650+ Packages *
900+ Packages *
1,200+ Packages *
1,600+ Packages *
2,024+ Packages *
Troops that achieve a 220+ package per girl average will receive matching Girl Scout's of Ohio's Heartland t-shirts for each participating Girl Scout. If your Girl Scout's troop achieves this level, what size t-shirt would she like?*

Reward Opt Out

Girl Scouts in Junior, Cadette, Senior, and Ambassador troops can unanimously decide to opt out of rewards in exchange for an additional $.05 per package in troop proceeds.
- The decision to opt out must be unanimous for all participating Girl Scouts.
- Girl Scouts in troops that opt out are still eligible to earn patches and attend the Stellar Seller Celebration.
- Troops that opt out are still eligible for the Troop Rewards.
- Troop cookie program coordinators whose troops have opted out of rewards will be notified by January 31.
I have discussed this opportunity with my Girl Scout and we understand that this decision must be unanimous for all participating Girl Scouts. If her troop is eligible to opt out of rewards, she votes to:*

Receive rewards and NOT earn an additional $.05 per package in troop proceeds.OPT OUT of rewards in exchange for earning an additional $.05 per package in troop proceeds.

Contest Item Pick Up

Girl Scouts have a chance to earn exclusive rewards for starting their 2024 Girl Scout Cookie Program strong! Learn more at https://www.facebook.com/GSOHProductProgram.
If my Girl Scout is a contest winner, we would like to pick up her reward from:*

Chillicothe Office - 1130 Western Ave., Chillicothe, OH 45601Columbus Office - 1700 Watermark Dr., Columbus, OH 43215Camp Molly Lauman - 9130 Big Bear Creek Rd., Lucasville, OH 45648 (Limited hours)Mansfield Office - 24 W. Third St, Suite 110, Mansfield, OH 44902Marion Office - 1713 Marion-Mt.Gilead Rd, Suite 208, Marion, OH 43302 (Limited hours)Zanesville Office - 3230 Bowers Ln, Zanesville, OH 43701
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