Girl Talk LeadHERship Defined Virtual Summit Registration

Thank you so much for wanting to join us for our Girl Talk LeadHERship Defined Virtual Summit! We've planned some great inspirational speakers, activities and resources. Before filling out the form below, please read the following:

1. Payment via PayPal is required to complete this online registration. If you are not ready to submit your payment now, please hold off on completing the form until the time you are ready to do so.

2. The $30 registration fee is nonrefundable. 

3. If you are in need of financial assistance, please click here to complete our scholarship application. If you are awarded a scholarship, we will contact you with further instructions, including a coupon code and details on how to use it. 

4. Our Summit is curated for girls 13-18, but all are welcome to join. 

5. This will be a virtual summit, the entire event will be held online.  All attendees are responsible for providing their own way to connect virtually and a device to view speakers/activities/etc.

We're very excited about the upcoming Summit! We'll send out an email as we get closer to the Summit date providing details, including viewing instructions, details about the Summit and resources.  Please make sure to check your junk email if you haven't seen an email in your inbox.

Summit Attendee Information

Parent/Legal Guardian of Attendee Information

If you are 18+ years old, please provide your name and email again below.

If you are under 18, then we require that you provide your parental/guardian information below to receive Summit details and information. All parents/legal guardians will be sent an email regarding Summit details.

CONSENT AND RELEASE AGREEMENT

REGARDING PHOTOS / VIDEOS / AUDIO RECORDINGS

            In consideration of my or my child's ("Participant") participation in the LeadHERship Defined Virtual Summit ("Summit") provided by Girl Talk, Inc. ("Girl Talk"), the Participant and/or Parent/Legal Guardian hereby agrees as follows:

1. Copyrights and Usage . I the Participant and/or Parent/Legal Guardian hereby grants to Girl Talk the right and permission, in respect of any photographs, videos and/or audio recordings which any of its members, officers, directors, employees, contractors, volunteers, representatives, successors and assigns may take or have taken of the Participant, or in which the Participant may be included with others, to copyright the same in the name of Girl Talk or otherwise; to use, reuse, publish and re-publish the same, in whole or in part, in conjunction with any printed matter in any and all media now or hereafter known, including web pages, electronic mails and the like, for illustration, art, promotion, advertising, fundraising or any other purpose; and to use the Participant’s own or a fictitious name, likeness and any statement made by Participant in connection therewith if Girl Talk so chooses, without payment or any other consideration.
2. Ownership, Modification and Publication . I the Participant and/or Parent/Legal Guardian understand and agree that any such photographs, videos and audio recordings, including without limitation all negatives, prints and digital reproductions thereof, shall be and will become the property of Girl Talk. I the Participant and/or Parent/Legal Guardian hereby irrevocably authorize Girl Talk to edit, alter, digitally compose, copy, exhibit, publish or distribute any such photographs, videos and audio recordings for purposes of publicizing Girl Talk’s programs and activities or for any other lawful purpose. In addition, I the Participant and/or Parent/Legal Guardian waive the right to inspect or approve the finished product or products or the advertising copy or printed matter, whether written or electronic, of any such material in which the Participant's likeness appears. Additionally, the Participant and/or Parent/Legal Guardian waives any right to royalties or other compensation arising or related to the use or publication of any such photographs, videos and audio recordings.
3. Release and Hold Harmless.  I the Participant and/or Parent/Legal Guardian releases, discharges, and agrees to hold harmless and defend Girl Talk and any and all of its members, officers, directors, employees, contractors, volunteers, representatives, successors and assigns from any liability by virtue of any reason in connection with the making and use of any such photographs, video and audio recordings, including blurring, distortion, alteration, optical illusion, or use in composite form, whether intentional or otherwise, that may occur or be produced in the making of said photographs, video and audio recordings or in any subsequent processing thereof, as well as any publication of them, including without limitation any claims for libel or violation of any right of publicity or privacy.
4. Severability. In the event that any portion of this Agreement is held to be invalid or unenforceable, the validity or enforceability of the remainder of this Agreement shall be unaffected and shall remain valid and enforceable to the full extent permissible under law.
5. Governing Law. This Agreement and any disputes arising under or in connection with it shall be governed by the laws of the State of Georgia. I the Participant and/or Parent/Legal Guardian hereby submit to the exclusive jurisdiction of the state and federal courts of the State of Georgia for the settlement of any and all such disputes.
6.  If Participant is considered a minor, then I certify that I am the parent or legal guardian of the Participant, or that I otherwise have the legal authority to represent Participant and act on his/her/they behalf. I have read and understood this Agreement. I hereby consent to and ratify this Agreement and agree, on behalf of myself , Participant and each of our respective legal representatives, heirs and assigns, to be bound by its terms. 

Release of Liability

I, ("Parent/Gaurdian signed below"), hereby give my permission for ("Participant listed above"), to participate in the Girl Talk Inc.’s (“Girl Talk”) Camp.  

I hereby release and hold harmless Girl Talk, its staff, chaperones, and volunteers, as well as staff and volunteers of all assisting groups and vendors, from any and all liability arising from my or my child’s participation in the LeadHERship Defined Virtual Summit.

I hereby certify that all information provided in this authorization is true, correct and complete and that I agree to abide by all rules, regulations and policies of Girl Talk.

I hereby agree, to the fullest extent permitted by applicable law, to indemnify and hold harmless and discharge Girl Talk, its governing board, directors, officers, agents, consultants, employees, independent contractors and volunteers (the “Released Parties”), from, against and for any losses, costs, expenses, claims, demands, suits, judgments and all other liabilities (including attorney’s fees, expenses and court costs), to which the Indemnified Parties may be subject as a result of any false statement contained in this Registration Form.

I hereby certify that all information provided in this authorization is true, correct and complete and that I agree to abide by all rules, regulations and policies of the LeadHERship Defined Virtual Summit. I understand that if any proves to be incorrect or incomplete that grounds for canceling any and all participation exists. I hereby agree, to the fullest extent permitted by applicable law, to indemnify and hold harmless discharge Girl Talk, directors, officers, agents, consultants, employees, independent contractors, members, partners, team members, and volunteers (collectively, the “Released Parties”), from, against and for any losses, costs, expenses, claims, demands, suits, judgments and all other liabilities (including attorney’s fees, expenses and court costs), to which the Released Parties may be subject as a result of any false statement contained in this Certification.

Confirmation

BY SUBMITTING THIS FORM, I UNDERSTAND I AM DELIVERING ELECTRONIC SIGNATURES THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Hitting Submit Form below will direct you to PayPal to complete your payment for the option you selected above. DO NOT HIT YOUR BACK BUTTON after hitting the submit button below. All of your information will be lost and you will have to restart the registration form from the beginning again. 

Please note, you are not fully registered for our Summit until this form is successfully completed and your payment has been processed.