School Based Girl Talk Enrollment Application

  • Date Format: MM slash DD slash YYYY
  • Please enter a number from 9 to 18.
    Girls must be between the ages of 9-18 to enroll.
  • Parent/Guardian Information

  • Medical Information

    This information will be used in the event of an emergency.
  • Emergency Contacts

    Please designate two (2) people we can contact if there is no answer when we attempt to reach you. These contacts MUST BE LOCAL.
  • Please Note

    Please note that contact information will be shared with Girl Talk staff/volunteers if programming transitions to virtual
  • Liability Clause

    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.
  • Grade Release

    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 weeks.
  • Attendance Policy

    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 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and a letter will be sent to the mailing address you provided notifying you that her membership in Girl Talk has been rescinded.
  • Curriculum

    In the Spring Semester, we will have two lessons that talk about physical health and hygiene.
  • Photo Release

    I hereby grant or deny permission to use the image of my child as marked by my selection below. Such use includes the display, distribution, publication, transmission or otherwise use of photographs, images, and/or video taken of my child for use in materials that include, but may not be limited to, printed materials such as brochures and newsletters, videos, and digital images such as those on the Girl Talk, Inc. website.
  • Medical Emergency Contact

    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.
  • Contact Outside Of Group

    I, the undersigned, do hereby grant or deny permission to Girl Talk, Inc and all approved volunteers to communicate with my child through the GroupMe application as marked by my selection below.