Lady Debs Registration Form 2019

CURRENTLY, MEMBERSHIP FORMS ARE ONLY OPEN FOR YOUNG WOMEN WHO ARE IN THE 9TH-12TH GRADE AND ATTEND PALM BEACH LAKES HIGH SCHOOL. WE WILL UPDATE YOU WHEN WE BEGIN ACCEPTING ELEMENTARY AND MIDDLE SCHOOL APPLICATIONS AND YOUNG LADIES FROM ADDITIONAL HIGH SCHOOLS.

Congratulations! We would like to welcome and thank you for your interest in Lady Debs (sponsored by Deb Life, Inc.). Lady Debs is an assembly of young ladies who have specifically CHOSEN to represent their school and community. These young women will be afforded the opportunity to participate in workshops and activities that will enhance them personally, academically, spiritually and physically. At the conclusion of the program, we will celebrate during an end of the year activity designed to present the young ladies to their families, friends, and communities as distinguished and productive young women of society.

LADIES, get ready for an exciting and fulfilling season! We will talk, laugh, cry and grow together; however, the rewards will be profound and long-lasting. We look forward to working with you and are excited for the milestones that we will reach together!

Member's Name

First Name Last Name

Name of School Currently Attending

Grade Level

Member's Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number

Area Code Phone Number

Email

example@example.com

Give a brief explanation of your reason(s) for joining or re-joining Lady Debs.

Parent's/ Guardian's Name

First Name Last Name

Phone Number

Area Code Phone Number

Email

example@example.com

Parent's/Guardian's Name

First Name Last Name

Phone Number

Area Code Phone Number

Email

example@example.com

I understand that Lady Debs and/or Deb Life, Inc. reserves the right to dismiss a member from the program if she does not comply with the academic or behavior policy, becomes disruptive within the program, is disrespectful to the program and its participants or violates the law.

Parent's/Guardian's E-Signature (Use your finger or a stylus.)

Clear

Student's E-Signature (Use your finger or a stylus.)

Clear

My daughter has permission to become an active member of Lady Debs and Deb Life, Inc. I understand that participation is voluntary and that I or my child can withdraw membership at any time.

Parent's/Guardian's E-Signature (Use your finger or a stylus.)

Clear

COMMUNICATIONS RELEASE:

The student listed above may be pictured and identified by name in print publications (e.g. newsletter, brochure, etc.) and digital/social media (e.g. website, Facebook, Instagram, etc.) published and distributed by Lady Debs and Deb Life, Inc. (IF YOU CHOOSE NOT TO ALLOW YOUR CHILD TO BE PICTURED AND IDENTIFIED VIA PRINT OR DIGITAL MEDIA, PLEASE DO NOT SIGN THIS SECTION ONLY.)

Parent's/Guardian's E-Signature (Use your finger or a stylus.)

Clear

Thank you for your interest in Lady Debs/Deb Life, Inc. We look forward to seeing you soon!

Lady Debs 2022