iShapeMe Circles – Spring 2025
Registration form is in three parts – Girl's Information, Parent/Guardian Information and Parent Survey.
Participant Information
Girl's Name
*
First Name
Last Name
Girl's Email
example@example.com
Girl's Phone Number
Please enter a valid phone number.
Girl's Birthdate
*
-
Month
-
Day
Year
Date
Current Grade Level
*
6th Grade
7th Grade
8th Grade
School
*
Race/Ethnicity:
*
Asian/Pacific Islander
Black (including African or Afro-Caribbean)
Hispanic or Latinx
Indigenous (including American Indian and/or Native)
Middle Eastern or North African
White/Caucasian
If you are involved in any other extracurriculars, sports or school leadership, please share your involvement with us:
Are you bilingual or multilingual?
Please Select
Yes
No
T-Shirt Size
*
Please Select
Girls Medium (7-8)
Girls Large (10-12)
Womens XS
Womens Small
Womens Medium
Womens Large
Which Circle would you like to join?
*
Simpsonville – Mondays from 4-5:30 PM at Location TBD
Greenville – Tuesdays from 4-5:30 PM at Pleasant Valley Connection
Greer – Wednesdays from 6-7:30 PM at Needmore Center
Parent/Guardian Information
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Parent/Guardian Email
*
example@example.com
Would you be interested in carpooling or drop-off?
Yes, please!
No, thank you!
Preferred Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
If your iShapeMe Girl have any allergies or medical conditions that we should be made aware of, please share:
Do we have permission to include your iShapeMe Girl in photos and videos? Photos and videos may be used for marketing on social media, websites, print materials, or other marketing channels for up to ten (10) years.
*
Yes
No
Due to the privacy of each of our girls and the nature of the community we aim to create, we do not allow parents or guardians to join our meetings. We share the topics covered in our weekly emails. Please acknowledge that you understand.
*
Yes, I understand
What are some topics that your iShapeMe Girl may benefit from discussing?
How did you hear about us?
Facebook
Instagram
Email
Family or Friend
Church Bulletin/Announcement
Back
Next
Parent Survey
This portion of the registration is to be completed by the parent or guardian. Not all questions require an answer. However, answering these questions not only helps us to gain a sense of who we are privileged to serve in our programs but also allows us to apply for grants to receive more funding for educational programming. We appreciate your help!
Race/Ethnicity of Parents/Guardians
*
Asian/Pacific Islander
Black (including African or Afro-Caribbean)
Hispanic or Latinx
Indigenous (including American Indian and/or Native)
Middle Eastern or North African
White/Caucasian
Level of Education of Parents/Guardians
*
Some high school, no diploma
High School Graduate (Diploma, GED or equivalant)
Trade/technical/vocational training
Some college credit, no degree
Associate degree
Bachelor's degree
Master's degree
Professional degree
Doctorate degree
Mother or Primary Parent Age
24 - 32
33 - 45
46+
Current Household Dynamics
Single Parent
Two Parent
Multi-Generational (Grandparent and Parent in home)
Type option 2
Household Income
Less than $30,000
$30,000 - $59,999
$60,000 - $99,999
Over $100,000
Which best describes your iShapeMe Girl?
Only child
Has siblings, only older
Has siblings, only younger
Has siblings, both younger and older
Adopted or fostered
Is religion practiced in the home?
Please Select
Yes, often
Sometimes/Irregularly
No
How comfortable do you feel talking to your iShapeMe Girl about grades, goal-setting and school?
*
Not Comfortable At All
1
2
3
4
Extremely Comfortable
5
1 is Not Comfortable At All, 5 is Extremely Comfortable
How comfortable do you feel talking to your iShapeMe Girl about friendships and day-to-day updates?
*
Not Comfortable At All
1
2
3
4
Extremely Comfortable
5
1 is Not Comfortable At All, 5 is Extremely Comfortable
How comfortable do you feel talking to your iShapeMe Girl about bullying, harassment and decision-making?
*
Not Comfortable At All
1
2
3
4
Extremely Comfortable
5
1 is Not Comfortable At All, 5 is Extremely Comfortable
How comfortable do you feel talking to your iShapeMe Girl about puberty, hygiene and body image?
*
Not Comfortable At All
1
2
3
4
Extremely Comfortable
5
1 is Not Comfortable At All, 5 is Extremely Comfortable
How comfortable do you feel talking to your iShapeMe Girl about her mental well-being?
*
Not Comfortable At All
1
2
3
4
Extremely Comfortable
5
1 is Not Comfortable At All, 5 is Extremely Comfortable
How comfortable do you feel talking to your iShapeMe Girl about internet safety and online predators?
*
Not Comfortable At All
1
2
3
4
Extremely Comfortable
5
1 is Not Comfortable At All, 5 is Extremely Comfortable
Submit
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