GS
GLA Member Agreement Participation Form
GS
GLA is committed to providing a safe environment for our members. As we begin to resume in-person activities, it is
important that we follow national, state, and local guidance to help minimize the spread of COVID-19.
Prior to participating in any in-person troop or group Girl Scout activities, I agree to:
Complete the GSGLA Self-Screening checklist prior to each in-person meeting, event, and/or activity.
Complete the GSGLA Assumption of Risk Waiver eForm prior to the first in-person meeting, event, and/or
activity. This e-Form must be completed once each calendar year.
Expectations/Conduct while conducting in-person activities.
Follow good hygiene practices.
o Wash hands thoroughly for 20 seconds or use hand sanitizer.
o Cover coughs and sneezes with an elbow or tissue and throw away after use.
Us
e social distancing.
o Maintain a 6-foot distance from others when possible.
o Refrain from hugs, handshakes, “high-fives”, and the friendship squeeze.
o Wear a face covering or mask.
Re
port COVID-19 positive test results to GSGLA. If your Girl Scout or a member of your family receives a
positive COVID-19 test result within 10 days of participating in a GSGLA troop in-person activity, please
report this to your troop leader and covid19@girlscoutsla.org
Staff will contact the families of anyone who
may have been exposed during the activity. All information will be kept confidential.
I
understand Girl Scout members are not required to participate in any activity. In-person participation is at the sole
discretion of each family. If my Girl Scout will participate in person, we will follow the guidance listed above to the best
of our ability.
Troop Number:
PRINT Girl Scout Name:
Parent/Guardian Signature:
PRINT Parent/Guardian Name:
Date:
V1 Edition Date: 3.19.21 | Pg. 1
