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South St. Paul Service Unit

Sock Hop Flyer and Permission Form
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So. St. Paul Service Unit's
          2nd Annual
 
Valentine Sock Hop
 
Friday, February 10th, 2006
           7:00-9:00 pm
       SSPHS Cafeteria
COST:  $5.00 per Girl Scout
ADDITIONAL COST:  $6.00 for a friend
 
Girl Scouts may bring a non-Girl Scout friend to this event,
with an additional cost of $6.00.
 
Registrations are due by Friday, February 3, 2006
------------------------------------------------------------------------------------------
 
REGISTRATION FORM
 
Name __________________________Troop Number _____________
Address  _________________________________________________
Phone Number _______________Name of Friend_________________
Amount Enclosed: $___________________
 
----------------------------------------------------------------------------------------------------------------
 
PERMISSION FORM
 
My daughter ______________________________ has permission to participate
in the South St. Paul Service Unit's 2nd Annual Sock Hop on Friday, February
10, 2006 from 7:00-9:00 pm.  She is in good physical condition and has not had
any serious illness recently.
 
During the activity I may be reached at:
Name ____________________________________________________________
Phone  ___________________________________________________________
Address __________________________________________________________
 
If I cannot be reached in the event of any emergency, the following person is
authorized to act on my behalf:
Name ____________________________________________________________
Address __________________________________________________________
Phone  ___________________________________________________________
Physician's name and phone _________________________________________
Hospital and address  _______________________________________________
 _________________________________________________________________
Additional remarks  _________________________________________________
 _________________________________________________________________
 
Parent/Guardian Signature_________________________________________
Date ________________________
------------------------------------------------------------------------------------------------------------------
Please send both REGISTRATION AND PERMISSION FORMS for EACH girl
attending to:
 
Cheryl Steiner
653 - 7th Ave. So.
So. St. Paul, MN  55075
 
 Questions?  girlscouts419@aol.com
 
 
 

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