Girls Group Registration & Consent Form

Girls Group Sign-up Form, Parental Consent, and Release for Activities
The Lethbridge Family Services Girls Group is open to any girl aged 10–18 who would benefit from peer connections and activities. The group encourages learning, communication skills, creative expression, and cross-cultural exchange through a variety of fun and educational activities and field trips on Friday afternoons. The form below includes registration for the group, as well as a waiver and release for all activities.
1. Child/Participant Information
Child/Participant Full Name:

First NameLast Name
Child/Participant Birthday: *
Day
Month
Year
2. Permission for Activities
- Where we go: examples include parks, libraries, the university, Youth One, the Boys & Girls Club, and other places.
- Safety: I know that activities have some risks. Staff will supervise, but they cannot stop every accident.
- Health: My child/dependant is healthy and can play.
3. Medical Help
Alberta Personal Health Number:
Please tell us about allergies and medical needs your child/dependant has:
For example: asthma, diabetes, dietary restrictions, or illnesses.
4. Photo Permission
Can we take photos or videos of your child during Girls Group activities, for our website, Facebook, posters, and promotions?
5. Going Home (pick up)
How will your child get home after Girls Group?
Name of person allowed to pick up your child/dependant:
6. Parent/Guardian Info
Parent/Guardian Name (Your Name):

First NameLast Name
Your Phone Number:
Your Email Address:
example@example.com
7. Secondary Contact
Secondary Contact Full Name:

First NameLast Name
Secondary Contact Phone Number:
For use in emergency, if we are unable to reach you by phone.
8. Parent/Guardian Signature
Parent/Guardian Signature:
Second Emergency Contact Full Name:

First NameLast Name
Should be Empty:

Girls Group Sign-up Form, Parental Consent, and Release for Activities

1. Child/Participant Information

2. Permission for Activities

3. Medical Help

4. Photo Permission

5. Going Home (pick up)

6. Parent/Guardian Info

7. Secondary Contact

8. Parent/Guardian Signature