Every Girl in a Tent Patch Request Form All current girl members of Girl Scouts River Valleys who spend at least one night in a non-permanent structure can earn an exclusive glow-in-the-dark Every Girl in a Tent patch. After your trip, simply share your tent camping story and a few other details by filling out this form. The patch request form may be submitted year round. Patches will be mailed after each of the following dates. December 31 March 31 June 30 September 30 Are you a Girl Scouts River Valleys member?*YesNoAdventure Club patches are exclusive to Girl Scouts River Valleys members only. Please join if you are interested in earning this patch.Your Name* First Last Your Email* Mailing Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Are you a service unit volunteer requesting patches for an upcoming service unit encampment?*YesNoTroop Number*Service Unit Number*To look up your service unit number, see our service unit directory.Program Level*Check all that apply. Daisy Brownie Junior Cadette Senior Ambassador Number of girls who participated*Of the girls who participated, was this anyone's first night camping in a non-permanent structure?*YesNoNot sureIf yes, how many?Month of your camping trip(s).*Check all that apply. January February March April May June July August September October November December Number of nights you camped during each trip.* Click the (+) button to add an additional trip.Please select your camping method.*Check all that apply. Tent Hammock Quinzhee Other Please list other camping method if not listed above.*(RVs, campers or cars do not qualify.)How was your tenting experience arranged.*Check all that apply. Troop event Service Unit event Council event Resident camp Family event Where did you camp?*Check all that apply. State Park National Park Local or Regional Park Girl Scout property Backyard Other Please list other camping location if not listed above.*Name or location of your camp*Share a camping highlight, special skill learned, or fun story from your trip.*Share a photo from your trip. Drop files here or Accepted file types: jpg, jpeg, png, pdf, tif. Accepted file types: .jpg, .jpeg, .png, .pdf, .tifWhich girl patches are you requesting?*Check all that apply. Every Girl in a Tent patch 5 night patch 10 night patch 15 night patch 20 night patch Winter Camping patch (must be between the months of November and March) Under the Stars patch (girls must camp outside of a tent) How many Every Girl in a Tent patches are you requesting?*How many 5 night patches are you requesting?*How many 10 night patches are you requesting?*How many 15 night patches are you requesting?*How many 20 night patches are you requesting?*How many Winter Camping patches are you requesting?*How many Under the Stars patches are you requesting?*I understand that the photographs, writing, artwork, audio, or video I am submitting (collectively referred to hereafter as “material”) may be used for any lawful purpose by Girl Scouts River Valleys or its approved media partners. I hereby hold Girl Scouts River Valleys free and harmless of any and all liability arising out of the subsequent publication and use of the submitted material.* Yes, I accept these terms.