Girl Scouts - Columbia River Council, Inc.

ACTIVITY ROSTER

Use this activity roster for any activity that takes place at a different day, place and/or time than your regularly scheduled Girl Scout troop meeting. List everyone in attendance with your troop (adults, included).  After filling in the information from the “Parent Permission for a Troop/Group Activity,” give this roster to your “at home” contact person who will know your whereabouts at all times. Submit a copy of your “Activity Roster” with your “Overnight Activity/Troop Travel Form.”

 

Fill in the fields below.  Print and distribute per above directions. 

 
Activity Information

GIRL SCOUT TROOP # 

GIRL SCOUT LEADER NAME

DAY PHONE #

EVENING PHONE #

EMAIL

DESTINATION

DEPARTURE DATE/TIME

RETURN DATE/TIME

GIRL SCOUT TROOP "AT HOME" CONTACT

PHONE #

 

 

List of Names
      x if yes
NAME PARENT/GUARDIAN NAME
PHONE		 ALTERNATE CONTACT FOR EMERGENCY
(OTHER THAN GUARDIAN)
NAME
PHONE		 C
H
I
L
D		 A
D
U
L
T

 

 R
E
G
I
S
T
E
R
E
D		 M
E
M
B
E
R

 

 

 

 Girl Scouts - Columbia River Council, Inc. * P.O. Box 2427 * 15171 SW Bangy Rd. * Lake Oswego, Oregon 97035-0096 * 1-800-338-5428 or (503) 620-4567 * Fax:(503) 598-6556