Girl Scouts of the Commonwealth of Virginia

4900 Augusta Avenue Richmond, VA 23230

KEEP WITH YOUR TROOP RECORDS

PARENT/GUARDIAN CONSENT AGREEMENT

(Personal Guarantee)
FOR PARTICIPATION IN THE 2014 FALL SALE AND 2015 COOKIE SALE
I,_______________________(print) am the parent/guardian of _______________________(print), a registered
member of Girl Scout Troop # ______. She has my consent to participate in the 2014 Fall Sale and 2015 Cookie Sale.
In giving my permission, I understand and accept full financial responsibility for all peanuts/cookies and money
received. As used in this paragraph, financial responsibility includes but is not limited to order taking, product receipt
and delivery, payment collection from customers and payment in full to the troop within predetermined deadlines that
will be communicated prior to the start of the sale. If I am unable to meet this obligation, and it becomes necessary for
the council to initiate collection procedures against me, I agree to pay all fees, including attorney fees (33 1/3% of
outstanding balance.)
Venue Clause:
Parent/Guardian expressly agrees to submit to personal jurisdiction in Virginia and agrees that the forum for any
litigation pursuant to this agreement or any other contract between GSCV and the Parent/Guardian whether suit is
brought by GSCV or the Parent/Guardian, shall be the county of Hanover, Virginia. This agreement shall be governed
by and construed in accordance with the laws of Virginia.
Interest:
Parent/Guardian agrees to pay service charges of 1.5% interest per month on any amount past due until paid, both
before and after judgment.
**A photocopy of a valid drivers license or photo ID from Virginia DMV will be accepted in lieu of social security
number.

1. Parent/Guardian (print) ____________________________________________________________

Date
Address __________________________________________________________________________
Street
city
state
zip
Daytime Phone __________________________ Home Phone _________________________
Place of Employee ___________________________________________________________
**SS # ______________________________ Signature _____________________________________

2. Parent/Guardian (print) ____________________________________________________________

Date
Address __________________________________________________________________________
Street
city
state
zip
Daytime Phone __________________________ Home Phone _________________________
Place of Employee ___________________________________________________________
**SS # ______________________________ Signature _____________________________________

THE TROOP LEADER CANNOT ACCEPT YOUR DAUGHTERS ORDER WITHOUT THIS
COMPLETED AND SIGNED AGREEMENT.