PARENT/ GUARDIAN PERMISSION (SG.

2)
Non-regular unit activities
Your daughter/ward has the opportunity to participate in the following Girl Guides of Canada activity/event.
Activity Guiders please complete this activity section.
Activity/event/camp: aser !uest "arty #vening $ate%s&:
'rom () *un )+ ,:--pm to ()
*un )+ .:--pm
ocation:
%facility name&
aser !uest )/-- 0t. aurent 1lvd.2 3ttawa2 3N
4he details of this activity/event/camp are e5plained on the attached Activity Plan (SG.1).
4he activity/event indicated a6ove falls outside what Girl Guides of Canada considers to 6e a 7regular unit activity.8 3ur
procedures re9uire that you review the planned activity%ies& and consider the following:
:n all activities there is an element of ris;. <hile Girl Guides of Canada and your daughter=s/ward=s Guider%s& ta;e
reasona6le precautions to minimi>e these ris;s2 this is no guarantee against in?ury or loss.
0ome of the ris;s associated with these types of activities include %6ut are not limited to&: scrapes2 cuts or 6ruises@
sprains2 strains or possi6le 6ro;en 6ones@ illness from ;nown or un;nown sources@ theft or loss of possessions@ and
unforeseen in?uries from activities2 e9uipment or actions of your daughter2 other participants or other people2 including
negligent actions. Although it is unli;ely2 the potential also e5ists for de6ilitating in?ury2 long-term incapacity and death.
Your daughter/ward=s Guiders will 6e following Girl Guides of Canada=s 0afe Guide which outlines safety
management practices. You are welcome and encouraged to review this document. A copy of 0afe Guide is availa6le
from www.GirlGuides.ca.
"articipants are e5pected to conduct themselves in a safe manner and to a6ide 6y the Girl Guides of Canada
0afe Guide procedures and Code of Conduct. Anyone who does not or whose actions ?eopardi>e their safety or the
safety of the group will 6e dealt with immediately. :f appropriate2 she may 6e sent home at the e5pense of
parents/guardians.
Permii!n "lease return this page to the Guider 6y
1" #$n 1% (mm&''&yy)
Name of girl:

has my permission to participate in
aser !uest "arty #vening
Name of activity/event/camp
on
() *un )+ ,:---.:--pm with the supervision arrangements outlined on the Activity "lan %0G.)&.
ist dates and times
(!ntact '$rin) activity: $uring the duration of the activity2 : may 6e reached at:

Address "hone Alternate "hone
:n the event of an emergency, if : cannot 6e reached2 the following person is here6y authori>ed to act on my 6ehalf:
Name:

Aelationship to participant:


Address "hone Alternate "hone
: have read and understood the information provided with this form as well as the details on the attached Activity Plan
(SG.1). : understand that there is a degree of ris; involved in these activities. After carefully considering all the ris;s
involved2 and having full confidence that reasona6le precautions will 6e ta;en for the safety and well-6eing of my
child/ward2 : authori>e my child/ward to participate in the activity as descri6ed a6ove and on the Activity Plan (SG.1).

I a)ree t! *r!vi'e $*&t!&'ate +ealt+ in,!rmati!n t+at may n!t -e !n t+e Per!nal .ealt+ /!rm (..1) c!m*lete' at
re)itrati!n. :f my daughter/ward re9uires medical treatment2 : understand that Girl Guides of Canada will ta;e initial
steps to secure medical advice and services and that : will 6e contacted as soon as possi6le2 or if unavaila6le2 the
emergency contact person noted a6ove.
Custodial parent or guardian
$ate:
Aelationship to
girl:
"rint name 0ignature
We protect and respect your privacy. Your personal information is used only for the purposes stated on or indicated by the form. For complete details, see our Privacy
Statement at www.girlguides.ca or contact your provincial office or the national office for a copy.
(--//-./-)%Aev (-)B/-.& CCB
Parental Permii!n
for non-regular unit activities
Parent 0 *leae ret$rn t+i +eet t! t+e G$i'er1