Register for Girls Academy

Registration is closed, but submit your information below to be added to our waiting list!

Student Information

Name

First Name

Last Name

Middle School

Enter the name of the school this student currently attends

Grade

Age

T-Shirt Size

Please select the appropriate adult size from the options below

Parent/Guardian Contact Info

Please enter contact information for this student's parent or guardian below

Name

Enter the name of a parent/guardian who can be contacted regarding Girls Academy

First Name

Last Name

E-Mail

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency/Medical Information

Secondary Emergency Contact Name

In case of an emergency, we will contact this person if we cannot reach the parent/guardian listed above

First Name

Last Name

Emergency Contact Phone

(###)

###

####

Preferred Local Hospital

Medical Conditions/Allergies

Please let us know if there are any medical conditions or allergies we should be aware of when planning our meals and activities.

Media Consent and Release

Please read the statement below and check the box complete registration

Through participation in Girls Academy, students may be included in digital and print media in an effort to promote Our Daughters' Village's programs and activities. This form gives us your consent to reasonably photograph and/or record your child to be featured in media as described above.

I agree