Girl Scouts River Valleys

Health and Safety Forms

Health History Form

Documents activities members should not participate in and authorizes first aid and emergency transport to a healthcare facility.

Safety-Wise

Comprehensive safety guidelines for all activities, programs, and events.

Incident Report and Claim Forms

Mutual of Omaha Claim Form

Activity incident insurance claim form.

Mutual of Omaha Claim Form - Spanish

Activity incident insurance claim form.

Accident Incident Report
Complete this form within 24 hours of an accident/incident.

Mutual of Omaha Insurance Information and Enrollment Forms

Mutual of Omaha Instructions

Use to determine which plan you should purchase for your outing or trip.

Sample Enrollment Form

Review to make sure all information has been included prior to submitting your enrollment to the council.

Plan 2 Enrollment Form

Member and non-member accident insurance.

Plan 3E Enrollment Form

Member and non-member accident and sickness insurance.

Plan 3P Enrollment Form

Member and non-member accident and sickness insurance.

Plan 3PI International Trip Enrollment Form

Member and non-member accident and sickness insurance for international trips.

Trip Roster

Complete and submit with all 3PI (International Trip) Enrollment Plans.

Can't find it?

Contact us