2026 Cookie Program Girl Scout Permission Slip

2026 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 2026 Girl Scouts of Ohio’s Heartland Cookie Program.*

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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.
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 2026 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 43215Mansfield 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
Should be Empty:

2026 Girl Scout Cookie Program