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GLAMSponsorships

GLAMGIRL PERMISSION SLIP FOR MINORS

We understand that obtaining signed permission is crucial for any event or activity. That's why we have a simplified and straightforward PERMISSION FORM for your convenience. As always, we prioritize the safety of our participants, and your signed form helps us ensure that everyone can enjoy the event with peace of mind.

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Permission Form

Please answer each question to the best of your ability to easily move forward to the next step. For any answer that doesn't apply to you put N/A!

Your First Name

Your Email

Your full address

Your Last Name

Your Phone Number

The minors age and date of birth who is joining the organization

What is the minors full name who is joining the organization?

Is your minor pregnant, already had the child or in an abusive relationship?

What do you want your minor to gain from our organization?

Do you have any other female minors ages 11-19 who may need our services?

What is the situation with your minor?

Does your minor have social media accounts, if so on what platform and what are your social media names?

Does your minor have anything on your criminal background? *

Yes

No

Does your minor have any allergies? *

Yes

No

If you minor has allergies, please list them below. IF NON, PUT N/A!

If your minor has a criminal background, please tell us more about it and when it happened?

What workshops do you give your child persmission to attend? * Required

Leadership Development

Financial Literacy

Mentorship Program

Bible Study

Entrepreneurship Training

Community Outreach

Self Love/Self Care

Technology and Social Media Workshops

Career Development

Self Defense

Parenting Class

Let Your Hair Down

Cooking Class

ALL OF THE ABOVE

Something Else

Are you interested in joining our organization as a member? *

Yes

No

More Info

Do you give your child pemission to photographed, if yes please keep in mind you will be giving us pemission to use the photo on our social media pages, website, and etc.? *

Yes

No

More Info

Do you give your minor pemission to videographed, if yes please keep in mind you will be giving us pemission to use the video on our social media pages, website, and etc.? *

Yes

No

More Info

Do you give your child permission to be picked up in our GLAMBus to go to in-person workshops or community events? *

Yes

No

More Info

Do you know anyone else who may benefit from our organization, if so please put their name and phone number in the box below?

What time(s) are you available to chat? * Required

Early morning (8AM-10AM)

Mid morning (11AM)

Afternoon (12PM-4PM)

Evening (5PM-9PM)

Weekend Anytime

Anytime

None of these times work for me, tell us more in the box below

Anything else you would like to share with us?

What date did you want your teenager to start? * required

I agree to the terms of useView Terms of Use

I want to subscribe to the newsletter.

Your Signature

Thanks for submitting, someone from our team will be in contact with you within the next 2-5 business days if we need anything else!

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Contact Us

Our non-profit organization is your gateway to get in touch with us. Our friendly and knowledgeable staff are always available to answer any questions you may have or provide assistance. You can reach us by phone, email, or by filling out the contact form on our website. We also have a mailing address if you'd like to send us something by post. We look forward to hearing from you and thank you for your interest in our organization.

First name

Last name

Email

Write a message

Thanks for submitting!

ADDRESS

Winter Haven Office:
301 3rd Street NW

Suite 210

Winter Haven, FL 33881

PHONE

+1 877.882.5379 (EXT 3)

EMAIL

getinvolved@girlsleaveamark.org

2023 Girls Leave A Mark, Inc. is a 501(c)3 non-profit that helps teen mothers and young abused women.

Copyright © 2023 by Girls Leave A Mark, Inc. Website created and powered by GLAMour Tag Consultation Services, LLC. All rights reserved.

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