Girl Empowerment Day
Girl Empowerment Day
June 24, 2023 at 10 am
Check-in 9:30 am
Check out 1:00 pm
Orangeburg County Conference Center
1643 Russell St
Orangeburg, SC

Contact Person: Jeanette Brown at 202-236-3663 or thesafeorg@yahoo.com

This event is for girls ages 11-17. The purpose of this event is to inspire, empower, encourage and educate girls to be who they are created to be. We will have special guest speakers, food, games, prizes and more.

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Youth Information
Youth Name
Address
Phone #
Grade
Age
Medical Condition
Food Allergies
Parent/Guardian Information
Parent/ Guardian Name
Phone #
Email
Emergency Person & Phone Number
Photograph Authorization
I hereby grant to S.A.F.E. and its representatives the irrevocable and unrestricted right and permission to use and publish photos of me, or my child, in which may be included for education, illustration, promotion, or other purpose in any manner or medium, and to use my name in connection therewith.

I hereby release the S.A.F.E. Organization and its representatives from all claims and liability relating to said photographs.

I am of legal age and have read the aforementioned and fully understand the contents thereof.

Parent/ Guardian Signature & Date *
Liability Waiver
My child has permission to participate in the Girl Empowerment Day. I will not hold the SAFE Organization, Orangeburg City Gym and/or Sponsors for any injury that occur.
Parent/ Guardian Signature & Date *
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