Girl Scouts of California’s CentralCoast

Simi Valley Service Unit

Event Application

Part 1: Event Information

This Event Application must be submitted to the SU Event Manager at least 30 days before the event. The SU Event Manager must approve the Event Application before any advertising begins and before any expenses are incurred for the event.

There are 3 pages to the Event Application that must be submitted for initial approval.

Page 1: Event Information

Page 2: Projected Budget

Page 3: Risk Management Plan

Event Director Information (Adult In Charge of Event)
Name: / Troop No.
Address:
Phone No.:
Email:
Event Information
Name of Event:
Date(s) of Event: / Start/End Times:
Site of Event:
Site Address:
Site Phone No.
Estimated Number of Participants:
Estimated Number of Volunteers:
List adult and girl volunteers who will be assisting with the event below:
Name: / Duties: / Phone Number:

Girl Scouts of California’s CentralCoast

Simi Valley Service Unit

Event Application

Part 2: Projected Budget

Name of Event: / Date of Event:
Estimated Number of Participants (maximum capacity for event):
Step 1 – Estimate Event Expenses
Site Fee / $
Food / $
Office Supplies/Mailings / $
Program Supplies / $
Badges/Patches / $
Equipment Expense / $
SU Adult Recognitions Allowance
(Mandatory $0.50 per participant) / $
Insurance (required only for non-Girl Scout participants, $0.11 per person, $5.00 minimum, obtained through council) / $
Miscellaneous Expenses (describe) / $
Total Estimated Expenses: / $
Step 2 - Determine Registration Fee
Divide your Total Estimated Expenses by the Estimated Number of Participants.
$ / divided by / = / $ / per participant
Step 3 - Estimate Event Income
Multiply your Registration Fee by the Estimated Number of Participants.
$ / times / = registration income / $
Other Income (describe) / $
Total Estimated Income: / $
Step 4 – Determine the Estimated Balance Remaining (Balance should be zero)
Subtract Total Estimated Expenses from Total Estimated Income.
$ / (Income) minus / $ / (Expenses) = Balance
Estimated Balance Remaining: / $
Event Director’s Signature / Date Signed
SU Event Manager’s Approval / Date Signed

*** Save all receipts to attach to the Event Final Report ***

Girl Scouts of California’s CentralCoast

Simi Valley Service Unit

Event Application

Part 3: Risk Management Plan

This form is to be used for:

1.Events with fewer than 200 participants that do not include an overnight stay.

2.Overnight events with less than 50 participants.

For events with more than 200 participants, or for overnight events with more than 50, an expanded Risk Management Plan, GSTC Form RM2, is required.

Risk Management
Coordinator: / Phone No.:
Name of Event: / Date of Event:

Explain Event Check-In and Check-Out Procedures:

Emergency:

Phone number for ambulance
(not always 9-1-1, confirm for your area):
Name of Nearest Hospital:
Hospital Address:
Hospital Phone Number:

Fire:

Address of Nearest Fire Station:
Phone No. (non-emergency):

Police:

Address of Nearest Police Station:
Phone No. (non-emergency):

Explain Event Emergency Evacuation Procedure:

Event Volunteer Assignments During An Emergency:

Documenter (Record keeper - writes down all activities as they take place)
Name: / Phone:
Telephone Coordinator (Makes emergency calls to proper authorities, contacts parents)
Name: / Phone:
Diversion Programmer (Develops diversion activities to keep event participants occupied)
Name: / Phone:

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