Lansing City Wide GGG Chapter
Grit, Glam, & Guts invites you to be a part of the Lansing, MI citywide chapter beginning in 2022! Chapters are teen-led and advisor-supported. Chapters will have a teen executive board, meet weekly, produce a teen-led project, and participate in community events.
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Parent/Guardian Full Name *
Parent/Guardian Phone Number *
Parent Guardian Email Address *
2nd Emergency Contact Name, Number, Relationship  *
Student First & Last Name *
Student Date of Birth *
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Where does the teen live? (City, State) *
Student Email Address
Student Phone
How old is your teen? *
What grade? *
What school does the teen attend? *
I am the legal parent or guardian of the student listed on this permission form. The student listed on this permission form is a female between the ages 12-17 and has my permission to be a member of “Grit, Glam & Guts”  Lansing Citywide Chapter.  I/we understand that the chapter will be under the supervision and direction of adult leaders and partners. I waive any claim against Grit, Glam & Guts, Good Girl Radio LLC, The Residential College in the Arts and Humanities (RCAH) at Michigan State University, and its approved leaders or partners. In case of medical emergency, I understand every reasonable effort will be made to contact me. If I/we cannot be reached, I/we, the parent(s) or legal guardian(s) of student named on this application, a minor, hereby authorize and consent to the physician selected by the approved leader, partner or chaperone to hospitalize and select proper treatment including but not limited to injection, anesthesia or surgery for the child. *
The parent/guardian does agree to grant permission to record the student named on this applicant participation on film, videotape, or audio tape, at the program and related events. They further agrees that any or all of the material recorded may be used, in any form, as part of any future production(s) and that such use shall be without payment of fees, royalties, special credit, or other compensation. This form shall be valid until such time that it is revoked by the undersigned. *
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