The House of Pearls Registration

A Girl’s Journey in a Journal Zoom Meetings
Mentee Name

First NameLast Name
Birth Date

MonthDayYear
Grade
Parent/Guardian Information
Name

First NameLast Name
Home Number
Format: (000) 000-0000.
Cell Number
Format: (000) 000-0000.
E-mail
example@example.com
Emergency Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number
Format: (000) 000-0000.
Alt. Phone Number
Format: (000) 000-0000.
Which activity or task do you find it most difficult to get your kid to engage in?
What are some things that your child likes to do that makes her feel happy and content?
Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by The House of Pearl's Organization Academy during the selected Zoom meeting. All Zoom meetings will be age appropriate and a safe space for your child. At House of Pearls, we host empowering sessions known as A Girls Journey in a Journal. These gatherings provide a safe and supportive space for girls to come together, openly discuss their challenges and triumphs, and offer mutual encouragement. Our mission is to foster growth, both individually and as a community, through heartfelt conversations and shared prayers.
During these meetings, we address a range of topics that resonate with the girls, helping them navigate through various aspects of life. We believe in creating an environment where every voice is valued, and where friendships are nurtured through understanding and shared experiences.
Furthermore, we understand that some matters may require more personalized attention. If any student feels the need for private counseling, we extend a warm invitation to reach out to us. With parental permission, we are here to offer guidance and support.
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Signature
Should be Empty:

A Girl’s Journey in a Journal Zoom Meetings