2010 GS-TOP Day/Twilight - Summer Extreme Guide

2010 Day/Twilight Camp and Summer Extreme

Contents Letter to Parents Volunteers Make It Happen 3 Introduction Letter 3

Summer at a Glance 8 Day/Twilight Camp Registration Information and Deadlines 4 Other Information 6 Day/Twilight Camp Sessions 13

Summer Extreme Adult Volunteers 3 Registration Information and Deadlines 4 Other Information 6 Abilene Programs 16 Amarillo Programs 17 Fort Worth Programs 18 Wichita Falls Programs 30

Financial Assistance Form 31 Center Section Summer Volunteer Application Day/Twilight Camp Registration Form Summer Extreme Girl Registration Form Summer Extreme Adult/Sibling Registration Form

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Dear Parents: With all the choices available to families these days, why should your daughter attend Girl Scout Day /Twilight Camp or Summer Extreme events? What is there about the experience that is beneficial to your child, to you and to your family, beyond the value of just any other summer activity?

The Girl Scout Leadership Experience takes girls on a journey, a voyage from where they are at the beginning to someplace new with adventures and discovery along the way. Girls learn about themselves and others as they gain knowledge and develop skills.

At the heart of the Girl Scout Leadership Experience, are what we call the 3 Keys to Leadership: Discover activities engage girls in exploring their values, skills and world.

Connect activities engage girls in teaming up and relating with others in a multicultural world.

Take Action activities engage girls in making a difference in the world.

Participating in summer activities provides excellent opportunities for girls to do these very things. Through Girl Scout summer programs, girls discover the fun, friendship and power of girls together; and through the many enriching experiences provided by Girl Scouts, they have lots of fun along the way.

With your daughter, please review the multitude of wonderful activities included in this publication.

While she becomes excited at the prospect of wheel throwing or learning to kayak, you will understand the life-long benefits of what she will learn. To add to the family fun, there are also activities for the whole family. Be sure to check those out.

We encourage you to make decisions with your daughter early about which activities she would like to attend and send registration forms in as soon as possible. The 2010 summer season of Girl Scouting promises to be fun-filled with lots of new friends to meet, lots of old friends to greet, and an exciting way to spend a summer. We hope you are part of the voyage!

In Girl Scouting,

Darlene McMurray Director of Program

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General Information

Welcome to the Summer Activity Guide!

The summer is packed full of wonderful activities for Girl Scouts to enjoy all summer long.

Browse through the guide and map out your summer voyage!

Important Dates to Remember April 1

Placement begins (All registrations received prior to or on that date will be included in a random draw for placement.)

June 5 – July 31 Day/Twilight Camp and Summer Extreme season *Registration closes seven days prior to start date

Volunteers Make It Happen Day/Twilight Camps • • • • • •

Rooted in Girl Scout traditions Licensed by the State of Texas. Camps offered in this guide meet the highest standards of safety set by Girl Scouts of the USA and the Texas Youth Camp Safety Act. Operated by trained volunteers. No paid staff workers.

Volunteers are needed in order to serve as many girls as possible.

Extra bonus for Day/Twilight Camp volunteers: your Girl Scout daughters attend for free!

For all volunteers over the age of 18, submittal of a Summer Volunteer Application, successful completion of a Criminal Background Check and a 90 minute “Play It Safe” training is required.

Interested in volunteering for a Day/Twilight Camp? Contact Megan Ibarra at 817-735-5326 or mibarra@gs-top.org.

Summer Extreme • • • • •

•

Partners with resources throughout our communities Provides high quality programs Also needs Girl Scout volunteers. Every Summer Extreme event MUST have at least two adult Girl Scout volunteers present.

For all volunteers over the age of 18, submittal of a Summer Volunteer Application and successful completion of a Criminal Background Check is required.

Provides wonderful activities for girls and families o Events for individual girl participation (not designed for whole troops) o My Family and Me – events for girls and their family members. Each girl registration for Summer Extreme for family activities must be accompanied by at least one adult (18-years or older) registration form; in cases of siblings, one adult may register with more than one girl. o My Buddy and Me – events for girls and an adult (usually a parent or adult family member) Grade Levels: Daisies (D): These events are open to girls entering K through 1st grade in the fall.

Brownies (B): These events are open to girls entering 2nd through 3rd grades in the fall.

Juniors (J): These events are open to girls entering 4th through 5th grades in the fall.

Cadettes (C): These events are open to girls entering 6th through 8th grades in the fall.

Seniors (S): These events are open to girls entering 9th through 10th grades in the fall.

Ambassadors (A): These events are open to girls entering 11th through 12th grades in the fall.

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Registration Information and Deadlines

Registration Information and Deadlines When: • • •

Placement of registrations begins on April 1. After April 1, registrations will be processed daily on a first-come, first-placed basis, until the sessions are full or until the close date.

Registration will close seven days prior to the event date or first day of camp, with no additions except those on the waiting list.

No on-site registrations!

How: • • • • • • •

•

Separate registration forms are required for each girl and each event/camp.

Please submit one check for all Summer Extreme events that your daughter is registering for and a separate check for all Day/Twilight Camp sessions she is registering for.

Registrations are not accepted by phone or email. If the fee is paid with credit card or Cookie Bucks, registrations can be faxed.

No on-site registrations or payment will be accepted Be sure to completely fill out each form and include signature and full payment.

Incomplete registrations will not be processed and will be returned.

The immunization history must show dates, including month and year. Terms like “up to date,”or “current” or “on file with the school” cannot be accepted. For religious or health exemptions, contact the Day Camp Registrar at 817-737-7272 or 800-582-7272.

Send form(s) with fee(s) to your local Regional Girl Scout Office or Service Center. If you live in the Abilene Region, send forms to the Fort Worth Office.

Amarillo Regional Office

North Richland Hills Service Center

6011 West 45th Avenue Amarillo, TX 79109 Office: 806-356-0096 Fax: 806-356-0099

8401 Boulevard 26, Suite 7 North Richland Hills, TX 76180 Office: 817-281-7578 Fax: 817-281-3180

Fort Worth Regional Office

Wichita Falls Regional Office

4901 Briarhaven Road Fort Worth, TX 76109 Office: 817-737-7272 or 800-582-7272 Fax: 817-735-5305

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2106 Kemp Boulevard Wichita Falls, TX 76309 Office: 940-723-4336 Fax: 940-723-1867

Fees and Placement • • • •

•

Girls who are not registered Girl Scout members must add a $12 membership fee with registration.

Full payment must accompany the registration form and can be paid in cash, credit card, check, money order, or with Cookie Bucks.

Cookie Bucks will not be refunded if cancellation procedures are not followed.

If sisters are registered Girl Scouts in Girl Scouts of Texas Oklahoma Plains and both participated in the 2010 Cookie Sale, a one-time transfer of any number of cookie packages from one sister to another can be made.

Cookie Bucks: $1 fee = $1 in Cookie Bucks Cookie Bucks may be used in increments of $1 to pay for girl fees only. Family and adult fees may not be paid using Cookie Bucks.

Specific Information for Day/Twilight Camps • •

Fees include a patch and camp souvenir.

Cookie Bucks: 400 packages = one full Day/Twilight Camp session

Specific Information for Summer Extreme •

Fees include a large Summer Extreme patch for the first event attended and a smaller patch for each additional event attended.

Financial Assistance We believe that all girls should have the opportunity to benefit from the Girl Scout program experience. We recognize that it may not be possible for all families to afford registration fees.

Depending on available funding, a limited amount of financial assistance may be available to cover part of, or the entire fee.

• An applicant for financial assistance must be a registered Girl Scout in Girl Scouts of Texas Oklahoma Plains.

• Financial Assistance applications will be processed on a first-come, first-served basis. All requests for financial assistance will receive a response. Applications are included in the back of this book.

• Only one application for financial assistance can be awarded each year, per girl.

Session Placement and Confirmation

Within two weeks of placement, parents will receive a written confirmation letter of placement or wait-list status.

Two weeks before the event, parents will receive a letter that will include additional information and directions to the Day/Twilight Camp location and a full address for Summer Extreme events.

Please do not call to confirm placement or wait-list status until at least April 15.

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Other Information

Waiting Lists: • •

If a session is full, parents will be notified that their daughter has been placed on a waiting list.

If space becomes available, parents will be contacted. If a girl cannot be placed, her fee will be refunded.

Cancellation Policy: • • • • • • • •

To cancel a registration for a summer event, contact your Regional Office either by phone or email.

If a participant cancels 7 days or more before the start of event, a refund of the activity fee, less 20%, will be given.

If a participant cancels 6 days or less before start of event, no refund will be given.

If a girl does not attend an activity, a refund will be made for medical reasons only. A written request for a refund, accompanied by a doctor’s statement, must be received within 30 days of the activity missed.

If the camp health supervisor sends a camper home for medical reasons, and the camper does not return to camp for the remainder of the time, a refund will be made on a pro-rated basis.

If a girl leaves the event or camp early for any reason other than a medical reason, no refund will be made.

If a girl is placed on the waiting list and cannot be placed, a full refund will be issued.

If the event or camp is cancelled, a full refund will be issued. Reasons for cancelling include, but are not limited to, severe weather or not reaching the minimum number of participants.

Other Information Adult Volunteers Volunteers for Day/Twilight Camp and Summer Extreme events must be registered adult members of Girl Scouts of Texas Oklahoma Plains and complete the Summer Volunteer Application found in this guide.

Submit the Summer Volunteer Application with your daughter’s registration form.

Specific Information for Day/Twilight Camp Volunteers •

• •

A Day or Twilight Camp informational session is required for all camp volunteers and will be provided at no cost. Adult volunteers will be notified by the Camp Director regarding dates and times of session.

Volunteering has a bonus! Girl Scout daughters of full-time Day/Twilight Camp volunteers attend for free.

School-age boys or preschool children of volunteers can also attend by registering using the Day/ Twilight Camp Registration form. Please send an insurance fee of $2 per child for boys or preschoolers. There may be a small additional fee to cover activities and meals for boys and pre-schoolers.

Specific Information for Summer Extreme Volunteers •

Except for family events, adults are not required to stay for Summer Extreme events unless they are volunteers.

Day/Twilight Camp Program Aide Opportunities One of the excellent Girl Scout Leadership Experience opportunities is to become a Program Aide. Program Aides are trained girls ages 12 – 17 who make a commitment to teach skills to younger Girl Scouts. Day/Twilight Camp provides an opportunity for Program Aides to accumulate service hours while honing leadership skills.

To apply as a Program Aide, girls must have completed a Basic Program Aide course plus either: 1) Program Aide Outdoor Skill Builder camping weekend or 2) Program Aide Day Camp Specialization.

Program Aides should complete a Day/Twilight Camp Registration form and a Summer Volunteer Application. Place both applications in an envelope marked “Day/Twilight Camp Program Aide,” and mail or take to your Regional Office. Camp Directors make decisions on how many Program Aides each camp needs and will contact the applicant within two weeks of placement.

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Summer Extreme Tagalongs A tagalong is a child not registered in the activity, (e.g. a sibling). Tagalongs are not covered by Girl Scout insurance and change the dynamics of the event, taking away from an equal learning environment for the girls and/or the event facilitator. Tagalongs may not attend Summer Extreme events.

Transportation Transportation to and from summer activities is the responsibility of the parent or guardian.

Girls with Special Needs Please let us know any special adaptations or accommodations necessary to assist your daughter’s participation in summer program. Be sure to attach a detailed note with the registration forms.

Questions Day/Twilight Camp •

Abilene/Fort Worth: Contact Megan Ibarra at 800-582-7272, ext. 408 or mibarra@gs-top.org.

Summer Extreme • •

Amarillo: Contact Vivian Cockrell at 806-356-0096 or vcockrell@gs-top.org.

Abilene/Fort Worth/Wichita Falls: Contact Stuti Mehta at 800-582-7272, ext. 305 or smehta@gs-top.org.

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Summer at a Glance (by grade level) All Grade Levels Date

Page

Title

Region

6/5

18

My Family and Me: Fishing!

FW

6/5

18

My Family and Me: Graffiti Abatement

FW

6/7-6/11

13

Granbury Twilight Camp - In the Tropics

FW

6/7-6/11

13

Trail Lake Day Camp - Under the Sea

FW

6/12

18

My Family and Me: Fishing!

FW

6/14-6/18

13

Abilene Twilight Camp - Wildlife Safari

AB

6/14-6/18

13

Pecan Grove Twilight Camp - Journey Around the World

FW

6/21-6/25

14

Sunshine Meadows Twilight Camp - Eco-Action

FW

6/21-6/25

14

Wooded Acres Twilight Camp - Santa on Vacation!

FW

7/10

28

My Buddy and Me: Yoga

FW

7/12-7/16

14

Bluebonnet Trails Day Camp - Medieval Times

FW

7/18

29

My Buddy and Me: Ceramics

FW

Date

Page

Title

Region

6/6

19

Daisy Spa

FW

6/8

19

Cupcakes with Daisies

FW

6/8

19

Friendly Daisy T-Shirt

FW

6/13

22

My Buddy and Me: Klay Kids

FW

6/17

17

Pioneer Summer at PPHM

AM

6/26

16

My Buddy and Me: Weather Watch Studio Tour

AB

6/28

26

Make the World a Better Place

FW

7/6

27

Courageous Painting on Canvas

FW

7/17

21

My Buddy and Me: Badge of Honor

FW

7/24

30

On the Road

WF

7/31

29

Child Safety and Self Defense Clinic

FW

Daisy

8

8

Summer at a Glance (by grade level) Brownie Date

Page

Title

Region

6/7

19

Puppets, Dolls, & Plays

FW

6/12

21

My Buddy and Me: Badge of Honor

FW

6/13

22

My Buddy and Me: Klay Kids

FW

6/13

22

Spa Escape for Brownies

FW

6/15

22

Cookies with Brownies

FW

6/17

22

My Space

FW

6/17

17

Pioneer Summer at PPHM

AM

6/26

16

My Buddy and Me: Weather Watch Studio Tour

AB

6/29

26

Building Art

FW

7/6

27

Paint Your Self-Portrait on Canvas

FW

7/10

30

Where has all the water gone?

WF

7/12

28

Colors and Shapes

FW

7/17

21

My Buddy and Me: Badge of Honor

FW

7/24

16

Arts and Crafts on the Frontier

AB

7/31

29

Child Safety and Self Defense Clinic

FW

Date

Page

Title

Region

6/10

17

Pioneer Summer at PPHM

AM

6/12

20

Digital Photography Basics

FW

6/12

17

Do It Yourself Workshop

AM

6/12

21

My Buddy and Me: Extreme Adventures Dyno-Rock

FW

6/13

22

My Buddy and Me: Klay Kids

FW

6/19

23

Power of One

FW

6/19

21

My Buddy and Me: Extreme Adventures Dyno-Rock

FW

6/22

24

Baking with Juniors

FW

6/26

25

Doggone that Training and First Aid!

FW

6/26

25

Horse Fan

FW

Junior

9

Summer at a Glance (by grade level) Junior (cont.)

Date

Page

Title

Region

6/26

16

My Buddy and Me: Weather Watch Studio Tour

AB

7/6

27

Paint Your Self-Portrait on Canvas

FW

7/11

22

Spa Escape for Junior

FW

7/13

28

Prints and Graphics

FW

7/17

30

Energy at all Levels

WF

7/17

25

Horse Fan

FW

7/24

16

Arts and Crafts on the Frontier

AB

7/24

23

Power of One

FW

7/31

29

Child Safety and Self Defense Clinic

FW

Date

Page

Title

Region

6/26

25

My Buddy and Me: Extreme Adventures Dyno-Rock

FW

7/6

27

Paint Your Self-Portrait on Canvas

FW

Cadette

Junior, Cadette, Senior, Ambassador

10

Date

Page

Title

Region

6/11

20

Balloon Sculptures for Beginners

FW

6/17

23

Kayak Basics

FW

6/17

23

Kayak Techniques

FW

6/17

22

My Space

FW

6/18

23

Glass Fusing

FW

6/26

20

Balloon Sculptures for Beginners

FW

6/27

25

BeadDazzled

FW

7/9

27

Intermediate Balloon Sculptures

FW

7/15

23

Kayak Basics

FW

7/15

23

Kayak Techniques

FW

7/24

29

Advanced Balloon Sculptures

FW

7/27

29

Create-A-Fashion

FW 10

Summer at a Glance (by grade level) Cadette, Senior, Ambassador Date

Page

Title

Region

6/5

18

Discover Scuba

FW

6/11

20

First Aid/CPR - Adult, Child, Infant

FW

6/11

19

Lampworking

FW

6/12

16

Babysitter Training

AB

6/12

30

Babysitter Training

WF

6/12

21

Spa for Teens

FW

6/14-6/18

14

Twilight Trails Twilight Camp - A Whale of a Time

FW

6/15

18

Discover Scuba

FW

6/19

18

Discover Scuba

FW

6/19

24

Masters of Disaster

FW

6/19

24

Wheel Throwing

FW

6/22

17

Art of the Music Poster

AM

6/24

24

Babysitter Training

FW

6/29

26

Healthy Desserts

FW

6/29

17

Impressionism: The Science of Light and Color

AM

7/10

16

First Aid/CPR - Adult, Child, Infant

AB

7/10

30

First Aid/CPR - Adult, Child, Infant

WF

7/10

27

Photography Advanced

FW

7/14

28

Flying High at Lockheed Martin

FW

7/17

24

Babysitter Training

FW

7/17

18

Discover Scuba

FW

7/21

28

Flying High at Lockheed Martin

FW

Senior, Ambassador Date

Page

Title

Region

6/30

26

Extreme Adventures at Dyno-Rock

FW

11

Day/Twilight Camp

Day/Twilight Camp Sessions

Granbury Twilight Camp - In the Tropics Ever wanted to visit the beaches of Hawaii? Then come hula your way through games, songs, crafts, and even catch some waves. Then finish the week with a fantastic Luau on Friday!

Grade: All Grade Levels Date: Monday, June 7 through Friday, June 11 (overnight on Thursday for Brownies and up) Time: 4:00 – 8:00 p.m.

Place: Reunion Court, Granbury Fee: $65.00 Contact: Megan Ibarra at 817-735-5326 or 800-582-7272, ext. 408 or mibarra@gs-top.org

Trail Lake Day Camp - Under the Sea Do you sit and think about how life would be under the sea? Then jump in and get ready for a week filled with games, songs, crafts and learning about the wonderful life under the sea!

Grade: All Grade Levels Date: Monday, June 7 through Friday, June 11 Time: 8:30 a.m. – 3:30 p.m.

Place: Trail Lake First Congregational, Fort Worth Fee: $85.00 Contact: Megan Ibarra at 817-735-5326 or 800-582-7272, ext. 408 or mibarra@gs-top.org

Abilene Twilight Camp - Wildlife Safari Take a journey through nature as you learn about all kinds of wildlife. Complete your journey with games, crafts, photography and an exploration at the zoo!

Grade: All Grade Levels Date: Monday, June 14 through Friday, June 18 Time: 5:00 – 9:00 p.m.

Place: Festival Gardens, Abilene Fee: $65.00 Contact: Megan Ibarra at 817-735-5326 or 800-582-7272, ext. 408 or mibarra@gs-top.org

Pecan Grove Twilight Camp – Journey Around the World Is your summer in need of adventure? Then come join the fun at Pecan Grove Twilight Camp. Surround yourself with friends while particpating in songs, games, crafts and a trip to the American Airlines Center were real flight attendents train! Plus an overnight to put your adventure skills to the test!

Grade: All Grade Levels Date: Monday, June 14 through Friday, June 18 (overnight on Friday for Brownies and up) Time: 5:30 – 9:30 p.m.

Place: Masonic Home, Arlington Fee: $65.00 Contact: Megan Ibarra at 817-735-5326 or 800-582-7272, ext. 408 or mibarra@gs-top.org

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Day/Twilight Camp Sessions

Twilight Trails Twilight Camp - A Whale of a Time Come by for a whale of a time! Learn about Hawaii and have a blast with crafts, games and a luau. You don’t want to miss this!

Grade: Cadette, Senior, Ambassador Date: Monday, June 14 through Friday, June 18 (overnight on Friday) Time: 4:00 – 8:00 p.m.

Place: Camp Burnett, Southlake Fee: $65.00 Contact: Megan Ibarra at 817-735-5326 or 800-582-7272, ext. 408 or mibarra@gs-top.org

Sunshine Meadows Twilight Camp - Eco-Action Sunshine Meadows this year will be exploring nature! Find out what really lives in creeks, hear from an experienced farmer, go fishing, and of course have a blast at camp with crafts, games, archery, cooking and everything in between! On the last day of camp get your sleeping bag ready and have a real camp experience with a campfire, skits and songs. Did someone say s’mores?

Grade: All Grade Levels Date: Monday, June 21 through Friday, June 25 Time: 5:00 – 9:00 p.m.

Place: G.A. Walker Property, Burleson Fee: $65.00 Contact: Megan Ibarra at 817-735-5326 or 800-582-7272, ext. 408 or mibarra@gs-top.org

Wooded Acres Twilight Camp - Santa on Vacation!

Feliz Natal! Happy Christmas! Joyeux Noel! Feliz Navidad! Merry Christmas! Learn how countries around the world celebrate this holiday. Experience the most wonderful time of the year with crafts, games, songs, cooking and stories. Who knows? Santa may drop by on vacation!

Grade: All Grade Levels Date: Monday, June 21 through Friday, June 25 Time: 5:00 – 9:00 p.m.

Place: East Broad Presbyterian Church, Mansfield Fee: $65.00 Contact: Megan Ibarra at 817-735-5326 or 800-582-7272, ext. 408 or mibarra@gs-top.org

Bluebonnet Trails Day Camp - Medieval Times Once upon a time in a land far, far away, there was a camp where princesses joined in fun filled festivities such as games, crafts, songs, and cooking. So grab your tiaras and get ready for a medieval good time!

Grade: All Grade Levels Date: Monday, July 12 through Friday, July 16 Time: 8:30 a.m. – 3:30 p.m.

Place: Redeemer Bible Church, Fort Worth Fee: $85.00 Contact: Megan Ibarra at 817-735-5326 or 800-582-7272, ext. 408 or mibarra@gs-top.org

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Summer Extreme

Summer Extreme Programs Abilene Region

ABILENE

(events listed in date order)

Babysitter Training Make your own money as a babysitter! Complete hands-on activities while learning basic care, safety, safe play, and first aid. Earn the American Red Cross Babysitter’s Training Certificate. Bring a sack lunch and drink. Must be age 11 at time of workshop.

Grade: Cadette, Senior, Ambassador Date: Saturday, June 12 Time: 8:30 a.m. – 5:00 p.m.

Place: Abilene American Red Cross Office, Abilene Fee: $55.00

My Buddy and Me: Weather Watch Studio Tour Have you ever been behind the scenes at a television studio? Come visit the news desk, give a weather report at the weather station, see the behind the scenes work of a news room, and visit with professionals in the television industry.

Grade: Daisy, Brownie, Junior Date: Saturday, June 26 Time: 2:00 – 2:45 p.m.

Place: KTXS Channel 12, Abilene Fee: $5.00

First Aid/CPR - Adult, Child, Infant Be prepared for an emergency! You will be able to recognize an emergency and get hands-on practice in both CPR and First Aid. Bring a sack lunch and drink. Earn the American Red Cross First Aid Certificate and the American Red Cross Adult, Child, and Infant CPR Certificate. Must be age 11 at time of workshop.

Grade: Cadette, Senior, Ambassador Date: Saturday, July 10 Time: 8:30 a.m. – 5:00 p.m.

Place: Abilene American Red Cross Office, Abilene Fee: $55.00

Arts and Crafts on the Frontier A fun sampler of authentic activities in both the then and now styles. Participants will be able to take completed projects home.

Date: Saturday, July 24 Place: Frontier Texas, Abilene Fee: $15.00 Grade: Time:

Brownie 9:00 – 11:30 a.m.

OR Grade: Time:

16

Junior 1:30 – 4:00 p.m.

Girl Scouts of Texas Oklahoma Plains, Inc.

DAY/TWILIGHT CAMP REGISTRATION FORM Form may be copied as needed. Please print clearly and use a pen with black or blue ink. Fill out entire form; incomplete forms will be returned and must be completed and resubmitted before a girl is placed. Mail or take the form with fee to your Regional Office or Service Center. If paying by credit card, you may fax the form; registrations will not be accepted by phone or email.

GIRL INFORMATION Camp name: Are you registering a:

Dates:

Camper Staff Child Program Aide

First name:

Last name:

Address:

City:

Phone:

Middle initial: State:

Zip:

Birthdate:

Grade in Fall 2010:

Registered, Troop #:

Juliette Not registered Out of Council? Council Name: Girl Scout Level in Fall: Daisy Brownie Junior Cadette Senior Ambassador  Non-GS Medicine Plants Hay Fever Allergies: Check those that apply and list specific nature of reaction. Animals Pollen Insect Stings Food Other Describe reaction: Immunization History (must have dates):

Month/Year primary series completed:

Month/Year last booster:

DTP

Varicella:

MMR

Hepatitis B:

Polio

PARENT/GUARDIAN INFORMATION Custodial parent/guardian name:

Primary Contact #:

Address (if different from above) :

Secondary Contact #:

E-Mail Address (for confirmations): Second parent/guardian name:

Primary Contact #:

Emergency Contact:

Primary Contact #: Secondary Contact #:

Address: Who will pick your child up from camp?

Drivers License #:

State:

I know of no reason, other than information indicated on this form, why my child should not participate in prescribed activities as noted. I give permission for my child to attend and participate in all activities related to this event. I understand some risk is inherent in a natural setting and in activities such as archery, horseback riding, swimming, canoeing and sailing. I understand safety equipment will be provided and agree that my child will be responsible for wearing protective equipment and following safety rules as instructed. I understand that there may be minimum skill requirements for some activities, and if my child does not meet them, she will not be allowed to participate in that activity. I will not allow her to attend the event if she becomes exposed to any contagious disease or if for any reason I do not consider her in good physical condition. Medications will be administered by or in the presence of the responsible adult and only with written permission from a legal guardian or physician. Medications should be in the original container, carefully labeled with the girl's name and dosage and must be accompanied with written instruction from a legal guardian or physician. In case of accident or illness, I authorize a representative of GS-TOP to give consent to a physician and/or hospital for medical and/or surgical treatment. It is understood that every effort will be made to notify me before such action is taken. I understand that GS-TOP may use photographs or audio/video of my daughter in event activities for publicity. I understand the Council cannot be responsible for loss of valuables. If not a currently registered Girl Scout, I give permission for her to join.

Date:

Custodial Parent/Legal Guardian signature:

FEE INFORMATION

METHOD OF PAYMENT

Camp fee:

+ $

$12 membership fee (if not a member)

+ $

Cookie Bucks: _____ Boxes or $_____

- $

Payment must be included with registration or it is incomplete.

Check enclosed payable to GS-TOP: Charge my credit card this amount: Credit Card type: (circle one) VISA

Sister-to-sister transfer: _______________________________________________________ Sister's name

Troop #

Exp. Date:

Registration: Staff Child or Program Aide

FREE

Cardholder’s name:

Total Due

$

Cardholder’s signature:

Date

Amt

Date: P/W:

Discover

Amex

Credit Card number:

- $

Camp: Fee:

$

# of Boxes

Financial Assistance Requested

Office Use Only:

MC

$

Type

Balance

Girl Scouts of Texas Oklahoma Plains, Inc.

SUMMER VOLUNTEER APPLICATION There shall be no discrimination in the recruitment, selection, learning opportunities, placement, retention and recognition of adult volunteers regardless of race, color, religion, sex disability, age or national origin.

VOLUNTEER INFORMATION I would like to apply for:

Day/Twilight Camp Volunteer Program Aide for Day/Twilight Camp

First name: Gender:

 Male  Female

Last name: Birthdate:

Address: Day Phone:

Are you a registered Girl Scout?

Social Security #: City:

Evening Phone:

Email:

Middle initial:

State:

Zip:

Cell Phone: Drivers License #:

Yes No If not, please include $12 membership fee with application.

If applying to be a Camp Program Aide, when did you complete the Basic PA course?

If adult, name of daughter(s):

School(s):

List any special skills or hobbies you would like to share with participants: Have you ever been convicted of, received deferred adjudication, or probation for a felony or misdemeanor?

Entering grade(s):

Yes No

If yes, please state the offense, date and location:

EXPERIENCE 1. Place:

Employee Volunteer

Supervisor name:

Address:

City:

Phone:

Employed from:__________________ to ___________________

2. Place:

State:

Zip:

Employee Volunteer

Supervisor name:

Address: Add

Cit City:

Phone:

Employed from:__________________ to ___________________

3. Place:

St State: t

Zi Zip:

Employee Volunteer

Supervisor name:

Address:

City:

Phone:

Employed from:__________________ to ___________________

State:

Zip:

REFERENCES Persons not related to you who can judge your qualifications for this position. If you have volunteer experience, one reference should be from them.

1. Name:

Address:

Phone:

Email:

2. Name:

Address:

Phone:

Email:

3. Name:

Address:

Phone:

Email:

Additional information: On another sheet, briefly list education, training, skills or other experiences that will enable you to carry out the responsibilities of the volunteer position you are seeking. Include experience in working with children, and your reason(s) for wanting to volunteer for GS-TOP. Girl Scout Promise On my honor, I will try: To serve God and my country, To help people at all times, And to live by the Girl Scout Law.

Girl Scout Law I will do my best to be honest and fair, friendly and helpful, considerate and caring, courageous and strong, and responsible for what I say and do, and to respect myself and others, respect authority, use resources wisely, make the world a better place, and

Signature: Office Use Only: Referral based on:

I have read the Girl Scout Promise and Law and will allow them to guide my actions. I certify that all information provided on this application is true and complete and that I have not knowingly withheld any information, which might, if disclosed, affect my application unfavorably. I understand that any misrepresentation or omission of facts on this application may be considered justification for non-acceptance or dismissal if discovered at a later date. I give permission for my references to be checked. I understand that appointment to a volunteer position is contingent upon the completion and review of a criminal background check.

Date: Appointment: (insert event name) Signature of Authorized Council Personnel:

Pending based on: Refusal based on:

Date:

Girl Scouts of Texas Oklahoma Plains, Inc.

SUMMER EXTREME ADULT/SIBLING REGISTRATION This form is to be used exclusively for Summer Extreme family events. This form my be copied as needed. Please print clearly and use blue or black ink. Fill out the entire form; incomplete forms will be returned and must be completed and resubmitted before a girl is placed. Attach this form to the Summer Extreme Girl Registration form and mail or take (with event fee) to your local Regional Office. Registrations will not be accepted by phone or email. A separate Adult/Sibling registration must be submitted for each person.

INFORMATION Registering a:

Boy Sibling Girl Sibling Adult

Birthdate:

First name:

Last name:

Address:

City:

Day Phone:

Evening Phone:

Sibling, grade in fall:

State:

Zip:

Email:

Emergency Contact:

Primary Contact #:

Address:

Secondary Contact #:

METHOD OF PAYMENT

Office Use Only:

Receipt:

Date:

Placed:

Refunded:

Adult/Sibling Summer Extreme Fee:

$

Check enclosed payable to GS-TOP: Credit Card: (circle one) VISA MC

Discover

Credit Card number:

Amex Exp:

Cardholder’s name: Waiting List:

Cardholder’s signature:

Girl Scouts of Texas Oklahoma Plains, Inc.

SUMMER EXTREME ADULT/SIBLING REGISTRATION This form is to be used exclusively for Summer Extreme family events. This form my be copied as needed. Please print clearly and use blue or black ink. Fill out the entire form; incomplete forms will be returned and must be completed and resubmitted before a girl is placed. Attach this form to the Summer Extreme Girl Registration form and mail or take (with event fee) to your local Regional Office. Registrations will not be accepted by phone or email. A separate Adult/Sibling registration must be submitted for each person.

INFORMATION Registering a:

Boy Sibling Girl Sibling Adult

Birthdate:

First name:

Last name:

Address:

City:

Day Phone:

Evening Phone:

Sibling, grade in fall:

State:

Zip:

Email:

Emergency Contact:

Primary Contact #:

Address:

Secondary Contact #:

METHOD OF PAYMENT

Office Use Only:

Adult/Sibling Summer Extreme Fee: Receipt:

Date:

Placed:

Refunded:

Check enclosed payable to GS-TOP: Credit Card: (circle one) VISA MC Credit Card number: Cardholder’s name:

Waiting List:

Cardholder’s signature:

$

Discover

Amex Exp:

Girl Scouts of Texas Oklahoma Plains, Inc.

SUMMER EXTREME GIRL REGISTRATION FORM Form may be copied as needed. Please print clearly and use a pen with black or blue ink. Fill out entire form; incomplete forms will be returned and must be cmpleted and resubmitted before a girl is placed. Mail or take the form with fee to your Regional Office or Service Center. If paying by credit card, you may fax the form; registrations will not be accepted by phone or email.

GIRL INFORMATION Event Title:

Date of Event:

First name:

Last name:

Address:

City:

Registered, Troop #:

Juliette Not registered

State:

Zip:

Birthdate:

School Grade in Fall 2010:

Phone:

Middle initial:

Out of Council? Council Name:

HEALTH HISTORY Allergies: (check all that apply and list nature of reaction)

Insect StingsOther

Animals Pollen Medicine Plants Food Hay Fever

Describe reaction:

Chronic and recurring illness: (check all that apply)

 Ear infection Asthma Seizures Diabetes Hypertension

Heart defect/disease Bleeding/clotting disorder Musculoskeletal disorder Other, specify:

Explain items that are checked: (indicate information useful to the adult in charge. Indicate activities to be restricted)

Other health conditions: (indicate any conditions which would impact her participation in this activity)

PARENT/GUARDIAN INFORMATION Custodial parent/guardian name:

Primary Contact #:

Address (if different from above) :

Secondary Contact #:

E Mail Address (for confirmations): E-Mail Second parent/guardian name:

Primary Contact #:

Emergency Contact:

Primary Contact #:

Address:

Secondary Contact #:

Specific transportation arrangements we should know about:

Check if parent/legal guardian would like to volunteer with activity.

I know of no reason, other than information indicated on this form, why my child should not participate in prescribed activities as noted. I give permission for my child to attend and participate in all activities related to this event. I understand some risk is inherent in a natural setting and in activities such as archery, horseback riding, swimming, canoeing and sailing. I understand safety equipment will be provided and agree that my child will be responsible for wearing protective equipment and following safety rules as instructed. I understand that there may be minimum skill requirements for some activities, and if my child does not meet them, she will not be allowed to partcipate in that activity. I will not allow her to attend the event if she becomes exposed to any contagious disease or if for any reason I do not consider her in good physical condition. Medications will be administered by or in the presence of the responsible adult and only with written permission from a legal guardian or physician. Medications should be in the original container, carefully labeled with the girl's name and dosage and must be accompanied with written instruction from a legal guardian or physician. In case of accident or illness, I authorize a representative of GS-TOP to give consent to a physician and/or hospital for medical and/or surgical treatment. It is understood that every effort will be made to notify me before such action is taken. I understand that GS-TOP may use photographs or audio/video of my daughter in event activities for publicity. I understand the Council cannot be responsible for loss of valuables. If not a currently registered Girl Scout, I give permission for her to join.

Date:

Custodial Parent/Legal Guardian signature:

FEE INFORMATION

METHOD OF PAYMENT

Summer Extreme fee:

+ $

Payment must be included with registration or it is incomplete.

$12 membership fee (if not a member)

+ $

Check enclosed (made to GS-TOP) Charge my credit card

Cookie Bucks: _____ Boxes or $_____

- $

Credit Card type: (circle one) VISA

Sister-to-sister transfer: Sister's name:

CC #:

Troop #:

Cardholder’s name:

# of Boxes:

Total Due

$

Cardholder’s signature:

Office Use Only:

Date

Amt

Camp: Fee:

Date: P/W:

MC

Discover

Amex

Exp. Date:

Type

Balance

Summer Extreme Programs Amarillo Region

AMARILLO

(events listed in date order)

Pioneer Summer at PPHM See the Museum come alive after hours. During this program Girl Scouts will have an old-fashioned picnic on the grounds, visit the T-Anchor pioneer home on the museum lawn, learn about how pioneers survived in the Texas Panhandle, explore exhibits, play games, and make pioneer crafts. If that is not enough, you may have the chance to meet the Pioneer Town ghost! Bring along a sack supper and drink.

Grade: Junior Date: Thursday, June 10 Time: 5:30 – 9:30 p.m.

Place: Panhandle Plains Historical Museum, Canyon Fee: $25.00 OR Grade: Date: Time: Place: Fee:

Daisy, Brownie Thursday, June 17 5:30 – 7:30 p.m.

Panhandle Plains Historical Museum, Canyon $15.00

Do It Yourself Workshop While working on this badge girls will discover learning how to make repairs can save money and lead to interesting careers. You will tour different departments and experience hands on activities and build your own project. Earn the Do It Yourself badge.

Grade: Junior Date: Saturday, June 12 Time: 9:00 – 11:00 a.m.

Place: Lowes Home Improvement Center, Amarillo Fee: $5.00

Art of the Music Poster: Rock Posters from the 60’s and 70’s This program will cover original prints from music albums and posters ranging from the early 1960’s psychedelic rock music through the late 1970’s punk rock movement. You will tour the museum, complete an art activity that includes printmaking and create your own rock poster.

Grade: Cadette, Senior, Ambassador Date: Tuesday, June 22 Time: 1:00 – 4:00 p.m.

Place: Amarillo Museum of Art, Amarillo Fee: $10.00

Impressionism: The Science of Light and Color Learn about the art of Impressionism through the 17th and 18th centuries. Spontaneous, bold and considered the rebels of their time, the artists of the Impressionist Period studied light, color and optics to improve their ability to capture a ‘moment in time’. You will experience the science and technique behind the Impressionist style of painting and do hands-on art projects.

Grade: Cadette, Senior, Ambassador Date: Tuesday, June 29 Time: 1:00 – 4:00 p.m.

Place: Amarillo Museum of Art, Amarillo Fee: $8.00

17

Summer Extreme Programs Fort Worth Region

FORT WORTH

(events listed in date order)

Discover Scuba Dive into life and discover the exciting world of scuba! After orientation and getting to know the equipment, try out your new skills and go for a scuba dive in a pool. Earn the Discover SCUBA Completion Card. You’ll also complete activities from Makin’ Waves Focus Award. Note: Certain health conditions may prevent you from participating. Refer to confirmation letter for more details.

Grade: Cadette, Senior, Ambassador Place: Arlington Scuba, Arlington Fee: $20.00 Date: Time:

Saturday, June 5 2:00 – 5:00 p.m.

OR Date: Time:

Tuesday, June 15 6:00 – 9:00 p.m.

OR Date: Time:

Saturday, June 19 2:00 – 5:00 p.m.

OR Date: Time:

Saturday, July 17 2:00 – 5:00 p.m.

My Family and Me: Fishing!

Bring your favorite family members (any sibling and adult), for a morning of family fishin’. Cover fishing and wildlife basics, and then you can bait a hook and enjoy fishing fun! Bring your own lawn chair or chair to sit on, and plenty of water. Limited fishing poles and bait provided.

Grade: All Grade Levels Time: 8:00 a.m. to noon Fee: $10.00 for girls, $10.00 for adults Date: Place:

Saturday, June 5 Rough Creek Park, Lake Granbury

OR Date: Place:

Saturday, June 12 Bear Creek Park, Keller

My Family and Me: Graffiti Abatement

18

A Community Service Project! You and your family will work together to help keep Fort Worth beautiful by painting a mural in a high graffiti area. Artistic skills are NOT a requirement. A special parental permission form is required and will be included in confirmation letter.

Grade: All Grade Levels Date: Saturday, June 5 Time: 9:00 a.m. to noon Place: Painting Site, Fort Worth Fee: $5.00 for girls, $5.00 for adults

Daisy Spa Special relaxation and girly fun for mom and Daisies. Let’s introduce the girls to a fun way to take care of themselves and have “me” time. Take home a sampling of spa goodies.

Grade: Daisy and Adult Date: Sunday, June 6 Time: 2:00 – 3:00 p.m.

Place: Girl Scout Center, Fort Worth Fee: $25.00

Puppets, Dolls, & Plays Learn and use many different art skills to make a finger puppet, yarn doll, and a recycled hand puppet.

Then work together to make a grand stage for a performance you will put on for parents and friends when they pick you up. You will complete all requirements to earn the Puppets, Dolls, & Plays Try-It. Grade: Brownie Date: Monday, June 7 Time: 1:30 – 3:30 p.m.

Place: Studio ARThouse, Southlake Fee: $25.00

Friendly Daisy T-Shirt Lend a helping hand! Daisies will work together to stamp, print, and paint original t-shirt designs inspired by the yellow learning petal, Friendly and Helpful. Yellow petal is not provided, but can be purchased from a Girl Scout Shop.

Grade: Daisy Date: Tuesday, June 8 Time: 10:30 a.m. to noon Place: Studio ARThouse, Southlake Fee: $22.00

Cupcakes with Daisies Decorate a dozen cupcakes to take home and share.

Grade: Daisy Date: Tuesday, June 8 Time: 1:30 – 3:30 p.m.

Place: Just Desserts by Marcie, Irving Fee: $15.00

Lampworking Lampworking is the art of making glass beads in a flame. Learn the essentials of heating a glass rod and wrapping it around a mandrel to form a bead, along with forming basic shapes and shop safety.

Grade: Cadette, Senior, Ambassador Date: Friday, June 11 Time: 6:30 – 8:30 p.m.

Place: Brushstrokes Studio & Gallery, Fort Worth Fee: $30.00

19

Summer Extreme Programs Fort Worth Region

Balloon Sculptures for Beginners Wouldn’t you love to know how to make balloon animals? Learn how to care for balloons, types of balloons, pumps, safety, and basic twisting techniques including inflation, tying, and locking twists. Fee includes your own balloon pump and a bag of balloons. Practice learning how to make a sword, a dog, a giraffe, hummingbird, rabbit and creative hats! Optional soft cover twisting book available at class for $5. (bring to class) Contact Program provider in advance to reserve book.

Grade: Junior, Cadette, Senior, Ambassador Time: 6:30 – 8:30 p.m.

Fee: $20.00 Date: Place:

Friday, June 11 Arlington Human Services Building, Arlington

OR Date: Place:

Saturday, June 26 Girl Scout Center, Fort Worth

First Aid/CPR - Adult, Child, Infant Be prepared for an emergency! You will be able to recognize an emergency and get hands-on practice in both CPR and First Aid. Earn the American Red Cross First Aid Certificate and the American Red Cross Adult, Child and Infant CPR Certificate. Bring a sack lunch and drink.

Grade: Cadette, Senior, Ambassador Date: Friday, June 11 Time: 8:30 a.m. – 5:00 p.m.

Place: Girl Scout Center, Fort Worth Fee: $55.00 Note: Earn the Emergency Preparedness Interest Project badge if you attend all of the following workshops: Babysitter, First Aid, CPR – Adult, Child, Infant, and Masters of Disaster. IP must be puchased separately.

Digital Photography Basics Learn camera basics of focusing, framing, shooting, proper storage when transferring files to your computer, cropping, printing, and burning a CD for proper archiving of your photos. Use a wildlife landscape session for examples. Bring your own digital camera, manual, snacks and water.

Grade: Junior Date: Saturday, June 12 Time: 9:00 a.m. to noon Place: Girl Scout Center, Fort Worth and Botanic Gardens, Fort Worth Fee: $35.00

20

My Buddy and Me: Badge of Honor The National Cowgirl Museum and Hall of Fame is the only museum in the world dedicated to honoring women of the American West who have displayed extraordinary courage and pioneer spirit in their trail blazing efforts. Visit a piece of history at the National Cowgirl Museum while working on your very own National Cowgirl Museum patch.

Time: 10:00 a.m. to noon Place: National Cowgirl Museum and Hall of Fame, Fort Worth Fee: $20 per girl/adult pair, $5 per additional girl Grade: Date:

Brownie, Adults Saturday, June 12

OR Grade: Date:

Daisy, Brownie, Adults Saturday, July 17

My Buddy and Me: Extreme Adventures Dyno-Rock (Junior) Designed to teach girls the fundamentals of climbing, belaying, safety, and a love of outdoors. Will focus on safety, commands, and practical experience while empowering the girls with a “Yes, I can!” attitude.

Must be accompanied by an adult. Special waiver must be signed and notarized, or accompanied by signing parent or legal guardian’s driver’s license, and will be included in the confirmation letter to be brought to Dyno-Rock.

Grade: Junior, Adults Time: 10:00 a.m. – 2:00 p.m.

Place: Dyno-Rock Climbing Center, Arlington Fee: $25 per girl/adult pair, $10 per additional girl Note: Must be accompanied by an Adult.

Date:

Saturday, June 12

OR Date:

Saturday, June 19

Spa for Teens Give yourself permission to enjoy an ESCAPE. Get together with friends to relax and catch up while you treat yourself to our Spa Experience. You will also work on skin-care and caring for hands, legs, feet, and lips. Take home a sampling of spa and skin care goodies.

Grade: Cadette, Senior, Ambassador Date: Saturday, June 12 Time: 2:00 – 4:00 p.m.

Place: Girl Scout Center, Fort Worth Fee: $35.00

21

Summer Extreme Programs Fort Worth Region

My Buddy and Me: Klay Kids Basics don’t have to be boring. Boost your creativity learning the basics of clay handbuilding while making your very own clay project. Projects are left at the studio to be fired and can be picked up one week after the event.

Grade: Daisy, Brownie, Junior, Adults Date: Sunday, June 13 Time: 4:30 – 6:30 p.m.

Place: Brushstrokes Studio, Fort Worth Fee: $20.00 per girl, $20.00 per adult

Spa Escape for Brownies Relax, play and try new ways to take care of yourself – hands, feet, lips, and face. Touch, feel, and put on new lotions and creams. Take home a sampling of spa goodies.

Grade: Brownie Date: Sunday, June 13 Time: 2:00 – 3:00 p.m.

Place: Girl Scout Center, Fort Worth Fee: $25.00

Spa Escape for Juniors The experience of a lifetime! Recharge yourself, unwind and regroup. A great way to release the stress of growing up. Take home a sampling of spa goodies.

Grade: Junior Date: Sunday, July 11 Time: 2:00– 4:00 p.m.

Place: Girl Scout Center, Fort Worth Fee: $30.00

Cookies with Brownies Bake and decorate a 10-inch round chocolate chip cookie to take home and share.

Grade: Brownie Date: Tuesday, June 15 Time: 1:30 – 3:30 p.m.

Place: Just Desserts by Marcie, Irving Fee: $15.00

My Space This is a creative workshop that combines ceramic painting and clay techniques for girls to design and create something fun for their room. Girls will choose from pencil holders, vases, or trinket boxes to paint and will create, build, shape, design, and paint a dry erase board out of clay. Glazing and firing is included in fee. Items will be ready to pick up at the studio two weeks after the event.

Grade: Brownie, Junior, Cadette, Senior, Ambassador Date: Thursday, June 17 Time: 6:00 p.m. – 8:00 p.m.

Place: Sunshine Glaze Creative Studio, Southlake Fee: $30.00

22

Kayak Basics

Have fun while learning the basics of kayaking through games and exercises designed to develop skills.

All equipment is provided. No experience necessary. Participants should be comfortable around water.

Grade: Junior, Cadette, Senior, Ambassador Time: 9:00 a.m. to noon Fee: $40.00 Date: Place:

Thursday, June 17 Pappy Elkins Lake, Dalworthington Gardens

OR Date: Place:

Thursday, July 15 Marine Creek Lake, Fort Worth

Kayak Techniques

Have fun maneuvering strokes and tricks to control your kayak. Develop the necessary skills to be comfortable and confident on the water by understanding and practicing water safety. All equipment will be provided. Prerequisite: Kayak Basics or have equal kayaking experience.

Grade: Junior, Cadette, Senior, Ambassador Time: 1:00 – 4:00 p.m.

Fee: $40.00 Date: Place:

Thursday, June 17 Pappy Elkins Lake, Dalworthington Gardens

OR Date: Place:

Thursday, July 15 Marine Creek Lake, Fort Worth

Glass Fusing

Learn the essentials of fusing and slumping glass to create a plate that is also decorated with colored glass frit. Projects are left at the studio to be fired and can be picked up one week after the event.

Grade: Junior, Cadette, Senior, Ambassador Date: Friday, June 18 Time: 6:30 – 8:00 p.m.

Place: Brushstrokes Studio & Gallery, Fort Worth Fee: $25.00

Power of One

See how the power of one can be the agent of change! Explore a piece of history at the National Cowgirl Museum while completeing the Power of One component to the Agent of Change Journey. Journey patch not provided, but can be purchased from a Girl Scout Shop.

Grade: Junior Time: 10:00 a.m. to noon Place: National Cowgirl Museum and Hall of Fame, Fort Worth Fee: $15.00 Date:

Saturday, June 19

OR Date:

Saturday, July 24 23

Summer Extreme Programs Fort Worth Region

Wheel Throwing Clay formed on a potter’s wheel is known as throwing. Participants will learn how to center clay and open it to create the initial wall and base, then you will with experiment with shape. Projects are left at the studio to be fired and can be picked up one week after event.

Grade: Cadette, Senior, Ambassador Date: Saturday, June 19 Time: 6:30 – 8:30 p.m.

Place: Brushstrokes Studio & Gallery, Fort Worth Fee: $30.00

Masters of Disaster Learn how tornadoes, thunderstorms and flash floods happen. Develop a family disaster plan and share it. Hands-on program with fun weather related experiments. Bring a sack lunch and drink. Note: Earn the Emergency Preparedness Interest Project patch if you attend all of the following workshops: Babysitter, First Aid, CPR – Adult, Child, Infant, and Masters of Disaster. (IP can be purchased from Girl Scout Shops.)

Grade: Cadette, Senior, Ambassador Date: Saturday, June 19 Time: 8:30 a.m. – 4:00 p.m.

Place: Keller Lions Club, Keller Fee: $28.00

Baking with Juniors Bake a 10-inch single layer cake of your choice (white or chocolate). Ice and decorate to take home and share.

Grade: Junior Date: Tuesday, June 22 Time: 1:30 – 3:30 p.m.

Place: Just Desserts by Marcie, Irving Fee: $15.00

Babysitter Training Make your own money as a babysitter! Complete hands-on activities while learning basic care, safety, safe play, and first aid. Earn the “American Red Cross Babysitter’s Training Certificate.” Bring a sack lunch and drink. Note: Earn the Emergency Preparedness Interest Project patch if you attend all of the following workshops: (Babysitter, First Aid, CPR – Adult, Child, Infant, and Masters of Disaster. (IP can be purchased from Council Shops.) Must be age 11 at time of workshop.

Grade: Cadette, Senior, Ambassador Time: 8:30 a.m. – 4:00 p.m.

Fee: $55.00 Date: Place:

Thursday, June 24 Girl Scout Center, Fort Worth

OR Date: Place:

24

Saturday, July 17 Keller Lions Club Building, Keller

Horse Fan Complete parts of the Horse Fan badge requirements as you learn different riding styles, how to groom and care for a horse, how to saddle a horse, and learn horse safety. This event includes a brief arena ride, if time allows. A special parental permission form is required and will be included in confirmation letter.

Grade: Junior Time: 9:00 – 11:00 a.m.

Place: Ride With Pride, Southlake Fee: $25.00 Date:

Saturday, June 26

OR Date:

Saturday, July 17

My Buddy and Me: Extreme Adventures Dyno-Rock (Cadette) Designed to teach girls the fundamentals of climbing, belaying, safety, and a love of outdoors. Will focus on safety, commands, and practical experience while empowering the girls with a “Yes, I can!” attitude.

Must be accompanied by an adult. Special waiver must be signed and notarized, or accompanied by signing parent or legal guardian’s driver’s license, and will be included in the confirmation letter to be brought to Dyno-Rock.

Grade: Cadette, Adults Date: Saturday, June 26 Time: 10:00 a.m. – 2:00 p.m.

Place: Dyno-Rock Climbing Center, Arlington Fee: $25 per girl/adult pair, $10 per additional girl Note: Must be accompanied by an adult.

Doggone that Training and First Aid! Do you own a dog? Do you want to own a dog? Learn tips and techniques on how to train as well as first aid for your pet. Demonstration dogs will be on hand to show you how to work with your pet at home.

Grade: Junior Date: Saturday, June 26 Time: 10:00 a.m. to noon Place: PetsWest, Aledo Fee: $15.00

BeadDazzled A course that is sure to catch your creative attention! Girls will enjoy making two pieces of jewelry for themselves or to give as a gift. Students will design and create their own bead bracelets and glass necklaces. The glass pendant will be fired at the studio and ready for pickup two weeks after the event.

Grade: Junior, Cadette, Senior, Ambassador Date: Sunday, June 27 Time: 3:00 – 4:30 p.m.

Place: Sunshine Glaze Creative Studio, Southlake Fee: $30.00

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Summer Extreme Programs Fort Worth Region

Make the World a Better Place Make a “Please Recycle” sign using mosaic tiles and recycled materials. Post this sign at home to remind friends and family to recycle. In addition, decorate a flower pot with paints and mosaic tiles, and then plant sunflower seeds. Take home your plant and give it to someone special as a thank you. Girls will earn the rose petal. This petal is not provided, but can be purchased from a Girl Scout Shop.

Grade: Daisy Date: Monday, June 28 Time: 9:30 – 11:00 a.m.

Place: The Art Barn Studio, Joshua Fee: $25.00

Building Art Do you have a love for new building designs? This is the class for you! Draw a sketch of your ideal building using an architect’s scale, make a model of a house, store, or building of your choice, become a city planner to design your own neighborhood, and draw a picture of what would be your perfect troop meeting place, all in a morning! Girls will earn the Building Art Try-It. Grade: Brownie Date: Tuesday, June 29 Time: 9:30 a.m. to noon Place: The Art Barn Studio, Joshua Fee: $30.00 Note: Building Art Try-It

Healthy Desserts Learn how to make your favorite desserts low calorie and healthy for you.

Grade: Cadette, Senior, Ambassador Date: Tuesday, June 29 Time: 1:30 – 3:30 p.m.

Place: Just Desserts by Marcie, Irving Fee: $20.00

Extreme Adventures at Dyno-Rock (Seniors and Ambassadors) Designed to teach girls the fundamentals of climbing, belaying, safety, and a love of outdoors. Will focus on safety, commands, and practical experience while empowering the girls with a “Yes, I can!” attitude.

Must be accompanied by an adult. Special waiver must be signed and notarized, or accompanied by signing parent or legal guardian’s driver’s license, and will be included in the confirmation letter to be brought to Dyno-Rock.

Grade: Senior, Ambassador Date: Wednesday, June 30 Time: 10:00 a.m. – 2:00 p.m.

Place: Dyno-Rock Climbing Center, Arlington Fee: $20.00

26

Courageous Painting on Canvas Paint on canvas in a beautiful palette of warm colors. We will mix original colors and learn awesome painting techniques as you paint an animal in the jungle that reminds you how to be courageous and strong. Girls will complete all requirements to earn the Red Petal. Petals are not provided, but can be purchased from a Girl Scout Shop.

Grade: Daisy Date: Tuesday, July 6 Time: 10:30 a.m. to noon Place: Studio ARThouse, Southlake Fee: $20.00

Paint Your Self-Portrait on Canvas Experience painting on canvas at an easel in a real art studio! You will learn how to draw realistic proportions of the face, use the color wheel to mix your paint colors, and learn about other artists’ styles of painting portraits to help you come up with your own great painting.

Grade: Brownie, Junior, Cadette Date: Tuesday, July 6 Time: 1:00– 4:00 p.m.

Place: Studio ARThouse, Southlake Fee: $35.00

Intermediate Balloon Sculptures Review previous techniques from Beginning class. Continue learning basic techniques, plus learn the pinch twist. Learn how to make a camel, alligator, snail, monkey, deer and duck. Bring your balloon pump from Balloon Sculptures for Beginners. Optional soft cover twisting book available at class for $5.

Grade: Junior, Cadette, Senior, Ambassador Date: Friday, July 9 Time: 6:30 p.m. – 8:30 p.m.

Place: Girl Scout Center, Fort Worth Fee: $17.00 Note: Must have attended Balloon Sculptures for Beginners, and must be comfortable inflating and tying balloons and have practiced before class.

Photography Advanced Learn camera basics of focusing, framing, shooting, proper storage when transferring files to your computer, cropping, printing, and burning a CD for proper archiving of your photos. Also learn the use of flash, settings on your camera, and rules of balancing. Use a wildlife landscape session for examples.

Bring your own digital camera and manual, snacks and water.

Grade: Cadette, Senior, Ambassador Date: Saturday, July 10 Time: 9:00 a.m. – 1:00 p.m.

Place: Girl Scout Center, Fort Worth and Botanic Gardens, Fort Worth Fee: $50.00

27

Summer Extreme Programs Fort Worth Region

My Buddy and Me: Yoga Yoga for focus, flexibility, fun, relaxation and stress relief. Sample some of the physical aspects of Yoga to improve focus and flexibility. We’ll add a variety of breathing and relaxation techniques to reduce stress and release tension, and add some partner poses and games for fun. No experience necessary If you can’t touch your toes – you need Yoga!

Grade: All Grade Levels and Adults Date: Saturday, July 10 Time: 11:00 a.m. – 12:30 p.m.

Place: St. Francis Catholic Church, Grapevine Fee: $15.00 for girls, $15.00 for adults

Colors and Shapes Use various colors and shapes to make and decorate greeting cards, create your own yarn painting, make a mobile out of clay, while seeing what crazy, colorful concoctions you can make! Girls will earn the Colors and Shapes Try-It. Grade: Brownie Date: Monday, July 12 Time: 9:30 a.m. to noon Place: The Art Barn Studio, Joshua Fee: $30.00 Note: Colors and Shapes Try-It

Prints and Graphics Create your own design from rubbings, make your own stamps to decorate a ceramic tile and frame, make a print from nature, create a stencil and decorate stationery, and complete a service project, too! Girls will earn the Prints and Graphics badge.

Grade: Junior Date: Tuesday, July 13 Time: 9:30 a.m. to noon Place: The Art Barn Studio, Joshua, TX Fee: $35.00 Note: Prints and Graphics badge

Flying High at Lockheed Martin Want to live life in the fast lane? Be involved in an automated wing-design program to develop a new wing which will allow an F-16 fighter jet to perform a new mission. Lunch with women engineers and hear about their careers. See what it’s like to fly high-performance aircraft through a tour of the state-of-the-art flight simulation lab. Requirement: Must be at least 10 years old and wear closed-toe shoes.

Grade: Cadette, Senior, Ambassador Time: 9:00 a.m. – 3:00 p.m.

Place: Lockheed Martin, Fort Worth Fee: $15.00 Date:

Wednesday, July 14

OR Date: 28

Wednesday, July 21

My Buddy and Me: Ceramics Sunshine Glaze enjoys hosting family outings. We believe that conversation and creative expression is a healthy combination for parents and their children. We will host this workshop for adults and girls to come and each pick a ceramic item to paint together. Any ceramic items in the store can be chosen, up to $20.

Firing and glazing is included in fee. Items will be ready to pick up at the studio one week following event.

Grade: All Grade Levels and Adults Date: Sunday, July 18 Time: 3:00 – 5:00 p.m.

Place: Sunshine Glaze Creative Studio, Southlake Fee: $25.00 for girls, $25.00 for adults

Advanced Balloon Sculptures Continue skills learned from Beginners and Intermediate class! Continue learning pinch and pop twists.

Learn advanced level creations of mouse, poodle, squirrel, teddy bear, bracelets, flower and advanced hats. Optional soft cover twisting book available at class for $5. Bring to class. Contact program provider in advance to reserve book.

Grade: Junior, Cadette, Senior, Ambassador Date: Saturday, July 24 Time: 6:30 – 8:30 p.m.

Place: Girl Scout Center, Fort Worth Fee: $17.00 Note: Must have completed Intermediate Balloon Sculptures, and must be able to inflate, tie and twist (locking and pinch) balloons on your own. Bring your pump from previous classes.

Create-A-Fashion This fashion forward class is for girls who like to create their own fashion. Each girl will enjoy designing and decorating their own tote bag with fabric, jewels, paint, whatever they can imagine! We will also teach the girls how to make their own wallet made of recycled products that will go great with their new tote bag!

Grade: Junior, Cadette, Senior, Ambassador Date: Tuesday, July 27 Time: 6:30 – 8:00 p.m.

Place: Sunshine Glaze Creative Studio, Southlake Fee: $25.00

Child Safety and Self Defense Clinic Join us for a fun-filled class covering child safety, awareness and self defense. The class is taught in a building block formation. Students will learn basic awareness skills, stranger education, lure awareness, assertiveness and basic self defense skills. Parents are not required to participate.

Grade: Daisy, Brownie, Junior Date: Saturday, July 31 Time: 10:00 – 11:30 a.m.

Place: The Gym, Arlington Fee: $15.00

29

Summer Extreme Programs Wichita Falls Region

WICHITA FALLS (events listed in date order) Babysitter Training Complete hands-on activities while learning basic care, safety, safe play, and first aid. Earn the American Red Cross Babysitter’s Training Certificate. Bring a sack lunch and drink. Must be age 11 at time of workshop.

Grade: Cadette, Senior, Ambassador Date: Saturday, June 12 Time: 8:30 a.m. – 4:00 p.m.

Place: Wichita Falls Red Cross Office, Wichita Falls Fee: $55.00

Where has all the water gone?

Complete most activities of the Wonders of Water Journey as girls learn to make a rainbow, learn about water conservation, make snacks, play games and additional activities incorporating water. Don’t miss this great day to teach the girls how to conserve water! Bring your own sack lunch and drink.

Grade: Brownie Date: Saturday, July 10 Time: 9:00 a.m. – 4:00 p.m.

Place: River Bend Nature Center, Wichita Falls Fee: $20.00

First Aid/CPR - Adult, Child, Infant Be prepared for an emergency! You will be able to recognize an emergency and get hands-on practice in both CPR and First Aid. Bring a sack lunch and drink. Earn the American Red Cross First Aid Certificate and the American Red Cross Adult, Child, and Infant CPR Certificate. Must be age 11 at time of workshop.

Grade: Cadette, Senior, Ambassador Date: Saturday, July 10 Time: 8:30 a.m. – 4:00 p.m.

Place: Wichita Falls Red Cross Office, Wichita Falls Fee: $55.00

Energy at all Levels Complete most activities of the Get Moving Journey by making paper beads, learning about energy and making paper, energy of different lights, plants, and water, create an energy pledge, observe the natural energy environments of animals, plus much, much more! Bring your own sack lunch and drink.

Grade: Junior Date: Saturday, July 17 Time: 9:00 a.m. – 4:00 p.m.

Place: River Bend Nature Center, , Wichita Falls Fee: $20.00

On the Road

30

Complete most activities of the Between the Earth and Sky Journey. Spend the day learning about conflict resolution, adding to your own nature journal of drawings, rubbings and words, learning greetings in other languages, the relationship between plants and water, a scavenger hunt of the Children’s Garden, and a service opportunity to give back to River Bend. Bring your own sack lunch and drink.

Grade: Daisy Date: Saturday, July 24 Time: 9:00 a.m. – 4:00 p.m.

Place: River Bend Nature Center, Wichita Falls Fee: $20.00

Girl Scouts of Texas Oklahoma Plains, Inc.

Instructions for Completing the Financial Assistance Application All sections applicable to your request are required on the reverse side. This form may be completed by a parent/guardian, a Girl Scout volunteer (such as a troop leader, or service unit manager), or a council staff member.

No refunds for programs already attended will be granted.

The form can be mailed, e-mailed, or faxed to the regional office for the appropriate camp, along with $25 non-refundable deposit and the registration form, although in order for financial assistance information to remain confidential, mailing the application is preferred.

Please note: 1. Financial assistance is based on financial need and the application should reflect that need.

2. Financial assistance is limited; however, the council makes every effort to provide enough support so that no Girl Scout in Texas Oklahoma Plains is denied participation due to lack of funds. If you have any questions, please call 817-737-7272 or 800-582-7272.

Instructions: Please be sure to check the girl or adult box to ensure appropriate processing of application.

Section I: This section is to be completed for all applications. In the instance of an adult applying for an adult learning opportunity there may be no troop number and those lines may be left blank. The grade level boxes can be checked for adult applicants, indicating the grade level of girls you volunteer with. The service unit name should be filled in. Juliette Girl Scout parents can use zeros for the troop number, write “Juliette” for troop leader and use the name of their nearest school if they do not know their Service Unit.

Section II: Household income helps determine the need for financial assistance.

Section III: This section is used when requesting uniform components and program materials. If request is granted, a voucher will be mailed to you to be used to obtain items from a council shop.

Section IV: This section is used when requesting assistance to attend a council event. Assistance granted will be applied to the event fee. Amount granted will be included in the confirmation notice.

Section V: This section is used when adults are requesting assistance to attend an adult learning opportunity offered by the council.

Notification of assistance will be e-mailed or mailed within two weeks of receipt of application.

National Membership Dues: To request assistance for these dues, use the form entitled “Request for Girl Scout National Membership Dues.”

A gift to the Girl Scouts of Texas Oklahoma Plains Annual Campaign ensures financial assistance is available for every girl or adult who needs help to participate in Girl Scouting.

Girl Scouts of Texas Oklahoma Plains, Inc.

Financial Assistance Application Do not use this form to request assistance for National Membership Dues. Please use blue or black ink pen. This form may be photocopied. To maintain confidentiality, put application in an envelope and mark it: Confidential; Attention: Financial Assistance, as instructed in “F”.

NOTE • In order to remove financial barriers to participation in Girl Scouts, limited funds are available to cover some expenses.

• Requests are reviewed on an individual basis.

• Financial assistance cannot be granted for troop activities. Troops are expected to budget for troop activities, outings, and other needs in their troop treasuries.

• This financial assistance request DOES NOT register the applicant for any event/learning opportunity. This request must be attached to the appropriate event/learning opportunity registration form.

• The council does not reimburse funds already spent.

How to apply for financial assistance A. All CURRENTLY registered girl and adult members are eligible to receive financial assistance.

B. A parent, troop leader or other adult may make a request.

C. Use one application per recipient.

D. Allow two weeks to process.

E. Refer to the Financial Assistance Guidelines on the reverse side of this form for more information.

F. Complete form and mail along with event registration form and mail to the appropriate Regional Office.

I. Personal Information Applicant’s name: ______________________________________________ � Girl

� Adult

or

� Check if non-troop affiliated

II. Estimated Household Income � Under $15,000 � $15, 000 - $25, 000 � $25 ,000 - $35,000 � $35,000 – 45,000

Troop # _____________ Service Unit: _____________________

� $45, 000 - $55, 000

� $55,000 or more

Address: ____________________________________________________ City: __________________________ State: ___________ Zip: __________ Grade Level: � Daisy � Senior

� Brownie

� Ambassador

� New Member

� Junior

� Cadette

� Adult-Position: ________________

� Returning Member Years in Girl Scouting:_______

Number of individuals supported by this income: ______ Number of dependents living at home: ______ Has any financial assistance been granted this year? � No � Yes If yes, please state amount $ ___________________________

Participated in most recent council product sale: � Yes � No

Why is financial assistance needed? ___________________

Amount of Cookie Bucks earned: $ __________

__________________________________________________

Name of Person completing application: ________________________

__________________________________________________

Position: __________________ Address: _________________________ City: __________________________ State: __________ Zip: __________ Phone: _____________________ Email: __________________________

__________________________________________________ __________________________________________________ __________________________________________________ __________________________________________________

Requestor’s signature: ________________________ Date: __________ III. Uniform Components, Insignia and Printed Materials FOR OFFICE USE ONLY Materials needed: ________________________________________________________ Date received:____/_____/______ Total Cost: $_____________ Amount approved: $__________ IV. Program Fees for council-sponsored events, day/twilight camp, or resident camp.

Assistance will be granted to cover a partial or full amount of the event fee.

Attach event registration form.

Event Name: __________________________________ Event Fee: $ ____________

Date approved: ____/____/_____ Notes:

Event Date: _____________

Amount Requested: $ _______________________

For Resident or Day/Twilight Camp – Camp__________________________________ V. Adult Learning Opportunities Includes council-sponsored learning opportunities.

Attach learning opportunities registration form.

Course Name: ___________________________________ Course Fee: $___________

Course Date: __________

Amount Requested: $ ______________________ 32

4901 Briarhaven Rd, Fort Worth, TX 76109 817-737-7272 • 800-582-7272 www.gs-top.org

Non-Profit Organization U.S. Postage PAID Permit No. 2277 Fort Worth, TX