Girls' Circle

Perry County Community Task Force

Helping today's youth become tomorrow's leaders

The Girls' Circle was formed in Perry County in 2014 and is open to girls in 7th and 8th grade. This program uses evidence-based curriculum to provide opportunities for girls to lead a life that includes being informed; making positive choices; experiencing shared power; and having positive options for a safe, healthy, and productive future.

Name of company providing medical insurance for this child *

Name & phone number of child’s physician: *

Girls' Circle

Public relations are an important part of the Girls Circle Program. Photographs are used in various print and electronic media to recognize members for their work and to let others know what is happening in Girls Circle. Should you prefer that your child not be photographed, we want to work with you to keep his or her photo from being taken. Because there are so many youths in Girls Circle, we cannot assure you that your child will not be photographed. We will ask Girls Circle’s photographers to honor individual’s requests not to be photographed. Please visit with your children about your wishes and encourage them to let photographers know that they request not to be photographed. Should a photo of your child be made and used against your wishes, please let us know so that it will not be used in the future

in the activities described above. I understand that I/my child will be under the supervision of the staff. I further consent to the conditions stated above on participation in these activities, including the method of transportation. If I cannot be reached in the event of a medical emergency, I give consent for the coordinator/assistant coordinator to obtain such medical care as is reasonably necessary for the welfare of myself/my child *

Child’s medical insurance policy number *

Date and time

I hereby request and consent to participation of (girl's name) *

Phone *

Helping today's youth become tomorrow's leaders

our staff

MENTORING FORMS

What's Happening on Facebook

FAQ

RELATED LINKS

Helping today's youth become tomorrow's leaders

our staff​

MENTORING FORMS

​What's Happening on Facebook

​FAQ

​RELATED LINKS

our staff

What's Happening on Facebook

FAQ

RELATED LINKS