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Please specify the name of your school.
Please indicate the number of individuals who reside in the household.
This information will be used in the event of an emergency.
Please designate two (2) people we can contact if there is no answer when we attempt to reach you. These contacts MUST BE LOCAL.
I grant unrestricted permission for my child's image to be used in print, video and digital media. I agree that these images may be used by Girl Talk, Inc. for a variety of purposes and that these images may be used without further notifying me. I do understand that my child's last name will never be used in conjunction with any photo, video or digital images.
In the event of injury, or should emergency care be required and I nor my emergency contacts can be reached, I grant Girl Talk, Inc. staff, volunteers and/or mentors permission to authorize emergency medical attention for my child.
I understand that participation in Girl Talk includes participation in any and all activities, field trips, or events. I also understand that all reasonable safety precautions will be taken at all times by Girl Talk, Inc. and its agents during the activity. I hereby grant permission for my child to travel off-campus for field trips with Girl Talk staff or volunteers.
I hereby indemnify and hold harmless Girl Talk, Inc. and its employees, agents, representatives and volunteers from any claims, damages, actions or causes of action arising or resulting from any bodily injuries, the effects thereof, or losses and damages arising therefrom, incurred or suffered by my child while in a facility or engaged in any organization sponsored activity, unless such loss or injury results directly from the gross negligence or willful act of any of the organization's employees acting within the scope of their employment or any of the organization's agents, representatives or volunteers.
At Girl Talk, Inc. we are training our girls to become successful women in today's society and we focus on ensuring academic achievement. I hereby agree to release a copy of my child's report card to Girl Talk staff and/or volunteers at the end of each 9 week grading period.
Your child's participation is very important. Our program is designed to assist in the development of your child and she will only get from it what she gives to it, which in this case, is her time. We want our girls to mature into bold and confident young women and our activities and events are tools to assist in this transformation. Girls must participate regularly to maintain their enrollment status. If your child misses three (3) consecutive activities or mentoring outings without any notice, it will be assumed your child no longer wishes to participate in Girl Talk, Inc. and a letter will be sent to the mailing address you provided notifying you that her membership in Girl Talk has been rescinded.