Girl Circle Registration
8-10- Week Program for youth ages 10- 13. Young women gain the vital opportunity to address female definitions and behavior and build their capacities to find their innate value and create good lives, individually and collectively.
Next Session will begin on Wednesday, October 2, 2019, and will be held at our office, 42 W. 8th Street in Tracy.
Email address *
Date of Request
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Participants First Name *
Your answer
Participants Last Name *
Your answer
Has the Participant ever attended a Sow A Seed program? (check all that apply) *
Required
Participant's Age (ages 10-13 only) *
Participant's Birth date (type in correct year) *
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Participant's School Name *
Your answer
Participant's Currant Grade *
Home Address *
Your answer
City *
If "Other" City, please list here
Your answer
Zipcode *
Your answer
Contact Phone Number (ie. xxx-xxx-xxxx) *
Your answer
Other Phone Number (ie. xxx-xxx-xxxx)
Your answer
I give permission for the participant listed above to Girl Circle. I also waive, release and discharge all claims for personal and property damages arising from my child's participation *
Required
Parent/ Guardian Name ( First, Last) *
Your answer
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