2345 GSVSC Program Publicity Request Form

For programs to be publicized on GSVSC web calendar, GS Connection weekly e-newsletter and Sky's the Limit publications and allow participants to register online using GSVSC registration system. Additional fees will apply when using GSVSC Doubleknot registration system.
PROGRAM EVENT DIRECTOR INFORMATION:
Your Name: *
Your answer
Your Email:
Your answer
Your Phone Number: *
Your answer
Name of person facilitating program: *
Your answer
Email of person facilitating program: *
Your answer
Phone number of person facilitating program: *
Your answer
Girl Scout Service Unit or County: *
Select the Girl Scout Service Unit or County of the program event location.
Who should participants contact with questions? *
PROGRAM EVENT INFORMATION:
Program Title: *
Your answer
New or Repeat Program? *
Required
Where is the program taking place? *
Girl Scouts of Virginia Skyline Council boundaries include the following counties: Alleghany, Amherst, Appomattox, Bath, Bedford, Botetourt, Buckingham, Charlotte, Charlottesville-Albemarle, Craig, Culpeper, Danville-Pittsylvania, Floyd, Fluvanna, Franklin, Galax-Carroll Giles, Grayson, Greene, Halifax, Highland, Louisa, Lynchburg-Campbell, Madison, Martinsville-Henry, Nelson, Orange, Patrick, Pulaski, Radford-Montgomery, Rappahannock, Roanoke-Valley, Rockbridge, Rockingham-Harrisonburg, Staunton-Augusta-Waynesboro, and Wythe
Required
Program GPS Physical Address: *
Provide program (GPS location) street address including city, state, and zip.
Required
Short Description of Program: *
Please provide a brief 5-10 word description of your program for the GSVSC Web calendar preview.
Your answer
Long Description of Program: *
Please provide a long description of your program for the website event descriptions. Be sure to include specific activities.
Your answer
Program Start Date: *
Please include all program session dates
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Program End Date (if multi-day or overnight event):
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Program Start Time: *
Time
:
Program End Time:
Time
:
Program Facility: *
Provide name of facility where program will be held. Ex. Camp Sacajawea, Trinity United Methodist Church, Bear Creek Lake State Park, etc.
Your answer
PARTICIPANT INFORMATION:
Who is the program for: *
Choose the applicable GS program level(s):
Required
Will participants receive any takeaways: *
(i.e.. participants will receive an actual badge, a fun patch, award, certificate, t-shirt, grab bag, trinkets, etc.)
List any participant takeaways:
(i.e.. participants will receive an actual badge, a fun patch, award, certificate, t-shirt, grab bag, trinkets, etc.) Skip if not applicable
Your answer
List GS Journeys or Badges that will be earned:
Skip if not applicable
Your answer
List GS Journeys or Badges that will be partially completed (please specify which requirements will be completed):
Skip if not applicable
Your answer
List T-Shirt sizes that will be available to participants:
Skip if not applicable
Your answer
Participation Types: *
Choose only ONE category:
Is this event open to the general public/non-GS members? *
I understand that I must purchase GS Activity insurance for events open to the general public/non-members. Note: Registered GS members do not need to be covered under "additional" GS Activity insurance. Girls in grades K-12 must be registered GS members in order to participate in all Girl Scout programs/activities. Adults ages 18+ (out of high school) must be registered GS members and have a cleared background check on file with council prior to participation in any GS event, trip or overnight. Tagalongs/siblings who are girls ages 0-Pre-K or boys ages 0-18 (still in high school) must be covered under GS activity insurance for their attendance at any GS programming or council activity.
Required
Program registration is required for: *
Check all that apply:
Required
REGISTRATION METHOD:
Type of Registration Method: *
Please indicate the type of registration method utilized for this program. Please note there are additional fees associated with GSVSC's online Doubleknot system. A program coordinator will contact you about fees when selecting GSVSC's online Doubleknot system. Please select your option below.
Required
If providing your own online registration, please provide your registration URL (Logic)
PROGRAM FEES:
Girl Program fee(s): *
Provide program cost per girl participant or indicate if free
Your answer
Adult Program fee(s): *
Provide program cost per adult participant or indicate if free. (An $8.00 adult non-member fee will be applied for one-day council-wide events for online registrations.)
Your answer
Tag-a-long Program fee(s): *
Provide program cost per child participant, indicate if free or type N/A if tag-a-longs are not allowed to participate.
Your answer
REGISTRATION DATES:
Date Registration Opens: *
Indicate the date you wish registration to be open to participants.
MM
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YYYY
Date Registration Closes: *
Indicate the date you wish registration to be closed to participants. Recommended 2+ weeks from event date.
MM
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DD
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YYYY
PROGRAM REGISTRATION MINIMUM & MAXIMUM:
Minimum number of program participants: *
Please indicate the minimum number of registered participants required to facilitate program.
Your answer
Maximum number of program participants: *
Please indicate the maximum number of registered participants allowed for this program.
Your answer
Program Categories: *
Check the one Define the categories that best fits this program.
Required
GS program pillars that best describes the type of program: *
Required
Which of the five GS outcomes will be achieved? *
Required
PARTICIPANT INSTRUCTIONS:
What do GIRLS need to bring or pack? (N/A if nothing) *
Your answer
Do you need any other information from the participants? *
(i.e. level of experience with rock climbing, swim test, waiver, shoe size, favorite color, favorite animal, etc.) (N/A if not applicable)
Your answer
What do PARENT/GUARDIANS need to provide? (i.e. Health History Forms/Parent Permission Form) *
Your answer
What Troop/Group positions or certifications are required for troop/groups to participate in this event (check all that apply): *
All program events for troop/groups require the participation of at least one trained troop co-leader and a troop first aider, and enough adult chaperones to meet the girl-to-adult ratios. All camping program events require the participation of one Troop Outdoor Education certified adult during the entire event. Troops/Groups can buddy-up with an experienced troop/group for their first camping experience. Refer to http://onlinetraining.vsgsc.org/courses/outdoor-updates for Buddy-Up camping guidelines. Event Directors are expected to verify this information with the Troop/Group prior to event.
Required
What additional information do TROOP CO-LEADERS need to know or provide? (N/A if nothing) *
Your answer
Parking instructions for participants *
Your answer
Check-in Location or name of meeting room (N/A if not applicable): *
Provide check-in location or Meeting Room: (if applicable). Ex. Multi-purpose, church fellowship hall, picnic shelter, etc.
Your answer
Additional Confirmation Email Info:
Please provide any additional details you'd like to provide registrants in their confirmation email:
Your answer
MISCELLANEOUS INFO:
Are volunteers needed? *
If yes, how many volunteers are needed and for what specifically?
Your answer
Additional comments, questions or special requests:
Please provide program staff with any additional comments, questions or special requests regarding your program publicity.
Your answer
Have photos and files to share? Please email your photos and files to communications@gsvsc.org
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