EmailMe Form - Troop/Group Travel Itinerary

Please indicate agreement by typing your initials in the box provided *

I have read the Troop/Group Travel Guidelines and have a conditionally approved Troop/Group Travel Application on file.

Troop #/Group Name:

Grade at time of travel(s):

Level: *

Destination:

Troop/Group Leader in Charge:

First Last

Phone

### - ### - ####

Email: *

Confirm Email:

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Service Unit: *

Service Unit Program Lead Name:

Phone

### - ### - ####

Emergency Contact Information

Note: Your emergency contact should be an adult who is NOT attending this trip.

Name:

Phone

### - ### - ####

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Drivers/Relief Drivers

1. Name:

2. Name:

3. Name:

Travel Agent/Tour Company

Name:

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Phone

### - ### - ####

Itinerary

Please complete the basic trip information below. You may use our Sample Daily Itinerary sheet in the Troop/Group Travel Packet.
Upload a daily itinerary that details the following:
-Lodging for each day, if it will be changing
-Planned activities for each day (Activity title and location)
-If traveling to a new location, please include mode of transportation (bus, flight, etc.), lodging, closest medical to new location, and closest US Embassy (International only)

Date and Time:

MM / DD / YYYY HH : MM AM/PM

Location:

Transportation Information:

Mode of Transportation (Car, Van, Boat, Train, Airplane, etc.):

Personal

Rental

Public

Make/Model of Vehicle:

Number of Passengers Vehicle Holds:

Airline:

Flight #:

Departure Time:

HH : MM AM/PM

Airport:

Arrival Time:

HH : MM AM/PM

Airport:

Other (Boat Carrier, Train, etc.)

Lodging Information

Dates:

From:

MM / DD / YYYY

To:

MM / DD / YYYY

Phone

### - ### - ####

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Daily Activities:

1. Name:

Address:

Phone

### - ### - ####

2. Name:

Address:

Phone

### - ### - ####

3. Name:

Address:

Phone

### - ### - ####

Meals: Please check if you have a plan for each

Breakfast:

Yes

No

Lunch:

Yes

No

Dinner:

Yes

No

Snacks:

Yes

No

Closest Medical

Name:

Address:

Emergency Number:

### - ### - ####

Distance in minutes by vehicle:

International Travel Only: Location of U.S. Embassy and Consulate

Address:

Phone:

### - ### - ####

Please upload daily itinerary here:

Daily Itinerary:

Trip Roster

Please upload a Trip Roster for all girls and adults attending that includes the following information:
-Names
-Address
-Phone Number
-Confirmation of registration and background screening (adults only). A check mark or yes column will suffice. Leaders can review background screening and registration through MyGS.

Trip Roster:

By signing this document, I verify that the above information is true and correct.

Troop Leader Signature: *

Clear

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