Girls Program Registration Form Spring 2024
This registration is for the Girls Mentoring Program at the Tracey Wyatt Recreation Center. This program meets on Wednesday from 6:15pm-7:30pm
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Email *
Parent Name (First and Last) *
Parent Phone Number
Parent E-Mail Address *
Child's Name *
Child's Birthdate *
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Child's Grade Level (2023/2024 School Year) *
Child's Shirt Size *
Does your child have an IEP or is special needs?  *
In Case of Emergency (Please include the relationship to the child) *
Please list all adults who are authorized to pick up your child. *
Please state any dates in which your child may not be in attendance.
Girls Aiming towards Positivity has my permission to use my or my child’s photograph publicly to promote the organization. I understand that the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use. By clicking the box below I am giving consent for my child to participate in this program. I accept all liabilities if my child(ren) contract COVID-19. *
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