AB-Council.07
GIRL GUIDES OF CANADA – ALBERTA COUNCIL
Provincial Event Registration Form
Send form with fee by date specified
To: Girl Guides of Canada Alberta Council
11055–107 Street NW Edmonton AB T5H 2Z7
Or e-mail/fax form with credit card payments to:
Fax: 780-426-1715
Note: Payment MUST accompany Registration Form
Name of Event: Alberta Girls’ Parliament
Date: March 22ndat 7pm to March 26th at 2pm, 2017
At Providence Renewal Centre, Edmonton Alberta
Applicant's Name:______Phone: ( ) ______
Preferred Name for Name Tag:______
Guiding Area: E-mail Address:______
Address: ______
NumberStreetTown/CityPostal Code
Health or Dietary Restrictions: ______
Additional information requested: ______
Girl: Applicant's iMIS Number: Applicant's Date of Birth ______
Day/Month/Year
For Group Events Contact person must be a registered Member with Safe Guide training.
Contact Person for the Group: Shannen Hoffman
Phone: (403) 201-3647 E-mail:
Pathfinders: Clerk or Sgt at Arms ____, only two positions available
Delegates: Registered Guiding members 15 years of age or older ____, Only 45 spaces
Method of Payment
❑ Cheque (made payable to Girl Guides of Canada/Alberta Council) Amount: $250 plus GST if AB Council member; $300 plus GST if GG of C but not AB Council, and $350 plus GST if from an organization other than Guiding. Please note this is by invite only if outside AB Council. The variation in cost is due to subsidy restrictions.
❑ Visa❑ Master Card Card #:______Expiry date:______
Card Holder's Name:______Signature: ______
Note: The responsible Guider for the event will notify you when your registration has been accepted.
Additional information may be requested at that time.
A list of participants for this event will be distributed at the event to allow you to communicate with each other during or after the event.Do you wish to have your name, phone number, e-mail address, and home address included on the list of participants? Failure to mark of either box will automatically place you on the participants list. No follow up phone calls or e-mails will be sent in this regard. Yes ❑ No ❑
Cancellation Policy: In the event of the participant canceling her registration in this event up to three weeks prior to event, 75% will be returned to the applicant. No refunds will be made if cancellation is received within three weeks (twenty-one days) of the event, except upon extenuating circumstances; documentation may be required.
We protect and respect your privacy. Your personal information is used to communicate within our organization. We do not provide or sell this information outside our organization. For further information, see our privacy statement at
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