Girls in the Spotlight Mar. 27 - May 1
Timnath 3rd, 4th and 5th grade girls only! Completing this form reserves a spot for the 5 weeks spring club season.
STUDENT INFORMATION
Child's First Name *
Child's Last Name *
Child's Grade *
Transportation Home *
Child's Youth T-Shirt Size *
Medical Conditions:
Other comments or information for the Coach?
CONTACT INFORMATION
Primary Contact (Parent/Guardian) First Name: *
Primary Contact( Parent/Guardian) Last Name: *
Primary Contact (Parent/Guardian) Phone Number: *
Primary Contact (Parent/Guardian) Email: *
ALTERNATIVE DEPARTURE
Please list anyone who you authorize to pick up your child in addition to the adult guardians listed above. All adults authorized for pick-up MUST present a photo ID at the time of pick-up.
Name:
Number:
LIABILITY WAIVER and MEDIA RELEASE
Liability Waiver: By signing below, you agree to the following:
On behalf of the above-named participant, I assume all risks of participating in this activity or event. I hereby waive, release, and discharge the Girls in the Spotlight Foundation (GITSF) from any and all liability, including but not limited to personal injury, property damage, property theft, or actions of any kind which may hereafter occur to the above-named participant by participating in this program.

In the event of a serious illness or injury, I hereby give permission to the GITSF staff to secure emergency medical care for the above-named participant, and agree to pay for any incurred expenses. I give permission to the GITSF staff to secure transportation (via ambulance) for the participant to the doctor or hospital and I release the GITSF from responsibility in connection with such emergency medical attention.
Type your name to agree to the waiver *
Copyright Waiver
Girls will be given the choice to enter artwork from our craft day into a contest. As the guardian I waive all claims of the copyright of my daughter.
Type your name to agree to the waiver *
Media Release Statement
I give my permission, for myself and/or my child to be photographed/videotaped/audiotaped during participation in the Girls in the Spotlight Foundation programs, camps or activities and for that photograph, audio or video image to be used for the purpose of promoting Girls in the Spotlight programs and events including, but not limited to, publication in brochures, newsletters, website, staff training, podcast content, music videos and grant projects. I understand that such photographs, audios or videos remain the property of the Girls in the Spotlight Foundation.
Media Release: Please choose Yes/No: *
Required
Type your name to provide electronic signature: *
How did you find out about this program? *
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