Etiquette & Fashion Summer Camp (Lake Charles)

Diva Dolls LC Etiquette, Grooming and Fashion

REGISTRATION FORM - Girls, 12yrs - 14yrs
Doll Name

First NameLast Name
Date of Birth

MonthDayYear
Current School
Grade
Course Amount*

$250
Parent/Guardian Information: (Must sign permission agreement below)
Parent/Guardian

First NameLast Name
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Mobile Phone Number

Area CodePhone Number
E-mail
Parent/Guardian Permission:

I give permission for my child to attend the DIVA DOLLS Girls Enrichment Program at 1622 Enterprise Bvd., Lake Charles, LA 70601, 10am-1pm. I understand that I am responsible for the full amounts due for workshops presented. There are no refunds. Future payments can be made via Paypal to alwaysvivid@aol.com.

I release the sponsors and owners of JPBranden Image Consulting from any liability. I am also aware that media personnel may be present to interview or photograph participants and I approve the release of such material. In case of an emergency, I give permission for my child to receive medical treatment that may be necessary for her. I understand that medical procedures will be billed to me or my insurance company.
Registration Fees:

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USD
Parent Signature (Full Name)
Should be Empty:

Parent/Guardian Information: (Must sign permission agreement below)