2022-2023 PBG Academy Registration Form

PBG Academy Registration Form - Patrick Henry

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 Patrick Henry Middle School. Sessions will be held on Thursdays and Fridays from 8am-8:47am PST for 6th-8th 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)
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 - Patrick Henry