Kids Night Out

Parent Authorization Form

Troop 2099 Babysitting FUN-raiser

I authorize the Girl Scouts and attending adults from Girl Scout Troop 2099 to care for my children on _________________, 1998 at ____________ Church in (city/state)___________________.

Signed: Relationship: .

My children’s names and ages are: Age Special Instructions

Name . .

Name . .

Name . .

Where can we contact you? Phone Number .

Who should be contacted in the event of an emergency?

Emergency Contact Person Phone Number .

Kids Night Out

Parent Authorization Form

Troop 2099 Babysitting FUN-raiser

Have a nice evening and thank you for giving us this opportunity!

Girl Scout Troop 2099

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Signed:	Relationship:	.
My children’s names and ages are:	Age	Special Instructions
Name	.	.
Name	.	.
Name	.	.
Where can we contact you?	Phone Number	.
Who should be contacted in the event of an emergency?
Emergency Contact Person	Phone Number	.