Girl Membership Form

Welcome to Girl Scouts!

This form is how to safely register for membership and process payment for your Girl Scout.

We respect your privacy: Info you share is kept confidential. Responses help us understand and support members, so we provide the best experience for all.
Tell Us About You and Your Girl!

Girl Scouts is open to all girls in grades K–12. Current membership is valid through September 30, 2026.
Already a member? Renew here.
Parent/Caregiver Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Were you a Girl Scout? Daisy, Brownie, or higher - it all counts.

YesNo
Caregiver's Ethnicity*
Caregiver's Race (Check all that apply.)*

American Indian or Alaskan NativeAsianBlack or African AmericanHawaiian or Pacific IslanderWhiteOther RacesI prefer not to share.Staff Use Only - Information not reported.
Caregiver's Gender*
Caregiver's Birth Date*

MonthDayYear
Date
Phone Number*
Your number will never be shared with third parties or affiliates for direct marketing. We maycall/text you.
E-mail*
example@example.com
Caregiver's Relationship to Girl*
Girl's Grade - Select the grade for your girl during the 2025-26 school year. Membership is open to ALL girls, kindergarten through 12th grade.*
Girls entering Kindergarten in Fall 2026 are eligible to join Girl Scouts starting April 1st. Would you like us to register your girl then or would you like to wait until fall.*

Register my girl now! She's so excited!!We're still deciding, please send me more information.
Girls that are not entering Kindergarten in 2026 are not yet eligible. Would you like to be contacted when your girl is eligible?*

Yes, she'll start kindergarten in Fall 2027.No, we'll reconsider on our own.
Girl's Full Name*

First NameLast Name
Girl's Ethnicity*
Girl's Race (Check all that apply.)*

American Indian or Alaskan NativeAsianBlack or African AmericanHawaiian or Pacific IslanderWhiteOther RacesI prefer not to share.Staff Use Only - Information not reported.
Girl's Birth Date*

MonthDayYear
Date
Tell us what school your girl currently attends. If in Pre-K, what school will she attend for Kindergarten?*
Enter School's Name Ex. Juliette Lowe Elementary
Girl's School Attending for Kindergarten*
Enter School's Name Example: Juliette Lowe Elementary
Girl’s Troop Preferences: We try to connect members with troops. If you already have adesired troop in mind, tell us the troop number, friend’s name, or leader’s name. Not sure? No problem! Tell us what’s convenient…troops that are close-to-home, at school, etc..
Is your girl enrolled in these Medicaid plans: Hoosier Healthwise, KChip, or CHIP?*
Some plans may qualify for Girl Scout related benefits.
Financial Assistance

Girl Scouts of Kentuckiana is dedicated to removing barriers and providing access to Girl Scout membership, and all financial assistance provided is made possible by our generous donors.
If the membership fee of $45 is out of reach, we want to help. Would you like to explore Financial Assistance?

No. I will join with the $45 fee.Yes. Show options for a reduced membership fee.
WHY: Financial circumstances shouldn’t prevent membership in Girl Scouts of Kentuckiana. Our local council can help lower your cost for the membership fee.

WHAT: We can help cover the membership fee through our generous donors. You pay what you’re able, and the remaining cost is supplemented by local donors who believe that every Girl Scout will benefit from a strong sense of self, develop positive values, seek challenges, build healthy relationships, and solve community problems.

HOW: We want to welcome your Girl Scout! If you need, consider the private options below. To supplement the $45 membership fee, select the option below which describes your ability to pay. Your membership fee will be adjusted before you pay. We depend on the trust and honesty of our members as we use limited funds to offset these membership fees.
Option

I'm able to pay 75% - or $33.75 - toward membership, and council donors cover the rest.I'm able to pay 50% - or $22.50 - toward membership, and council donors cover the rest.I'm not able to pay toward Girl Scout membership, and 100% of the membership fee will be covered by donors.
Membership Fee Calculation
Credit Card Payment: When you click Submit, a new window opens automatically for PayPal. No worries, you can pay securely with a credit/debit card. A PayPal account is not necessary.
Membership Costs (active through September 30, 2026)

prevnext( X )
USDDescription
By submitting this membership registration form, you confirm that you understand and agree to adhere to Girl Scout Child Abuse Prevention Policies and Procedures.
Name of adult submitting this form (if we have questions)*
Should be Empty:

Tell Us About You and Your Girl!

Financial Assistance