2022-2023 PBG Academy Registration Form

PBG Academy Registration Form - LAUSD Region North

Pretty Brown Girl is dedicated to empowering Black and Brown girls. You are receiving this form because your student has an opportunity to participate in Pretty Brown Girl Academy at LAUSD Region North. Sessions will be held once a week on Tuesdays or Thursdays from 4pm-5pm PST for 3rd-5th grade girls. If you have any questions completing the form, please contact LaTonya Reese at lwalton@prettybrowngirl.com.
Student Name*

First NameLast Name
Student Grade Level*
Student Email (if applicable)
Student Home Address*

Street Address

Street Address Line 2

CityState

Postal / Zip Code
What school does student currently attend?*
Please select the name of the school.
Please select which session works best for your student to attend weekly.*
T-Shirt Size*
Please note that one complimentary T-Shirt will be provided for the student. All PBG T-Shirts come in unisex sizes with a looser fit. Please review the sizing chart below to ensure the correct size is selected before submitting this form. Exchanges will not be permitted.
Parent/ Guardian Name*
Parent/ Guardian Email*
Parent/ Guardian Phone*
Relationship To Student*
If other, please share
YesNo
YesNo
Do you agree to our Terms and Conditions?*
Should be Empty:

PBG Academy Registration Form - LAUSD Region North