Program Registration Form - KIPP DC Valor Academy
You are receiving this form because your student has an opportunity to participate in the Pretty Brown Girl Program at KIPP DC Valor Academy. Sessions will be held for 5th-8th grade girls on Wednesdays from 4pm-5pm EST. If you have any questions completing the form, please contact LaTonya Reese at lwalton@prettybrowngirl.com.
Student Name
*
First Name
Last Name
Student Grade Level
*
Please Select
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Student Email (if applicable)
T-Shirt Size
*
Please Select
Adult Extra Small
Adult Small
Adult Medium
Adult Large
Adult Extra Large
Adult 2XL
Adult 3XL
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.
Did you review the sizing chart before selecting the Student's T-Shirt size?
*
Yes
No
Parent/ Guardian Name
*
Parent/ Guardian Email
*
Parent/ Guardian Phone
*
Relationship To Student
*
Please Select
Mother
Father
Stepparent
Grandparent
Aunt
Uncle
Other
If other, please share
Do we have your consent for the student to participate in the Pretty Brown Girl Program?
*
Yes
No
Do you agree to our Terms and Conditions?
*
Parent/Guardian Signature
*
Submit
Should be Empty: