Precious Pearls Mentoring Registration Forms 25-26

Precious Pearls Mentoring Registration

2025-2026 Mentoring Session
Monthly dues support the maintenance of our clubhouse and programs. A portion of these dues is allocated for lesson materials, snacks, members-only apparel, and select community events and outings.

*PPM offers payment options for monthly dues*

$50 Annual Enrollment - $25/Monthly Dues Sibling/Family discount available

Please don't let the cost be a hindrance to enrollment; we never want a pearl to miss out due to finances. We are more than willing to work with you.

*Scholarships are provided based on availability and eligibility. **ALL fees are non-refundable*
Child's Name
Childs Phone
Format: (000) 000-0000.
Date of Birth

MonthDayYear
Date
Current Age
Address
School
Parent/Guardian Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship
For the safety of our Pearls, we will need to know all food Allergies your child has.
Areas of concern you would like us to work on with your child.
1.
2.
3.
Parents Signature

Clear
RELEASE OF LIABILITY FORM
I agree to take responsibility for my child's conduct and actions and release Precious Pearls Mentoring (PPM) from any liability. This waiver applies to any behaviors or actions during PPM sessions, activities, and workshops at 1507 North Leg Rd, Augusta, GA 30909, every Saturday from 12:00 PM to 2:00 PM, as well as any special off-site events. Furthermore, I agree to release PPM and its staff/volunteers from any liability arising from incidents or accidents involving my child while on the premises, to the extent permitted by law.
Childs name
Name of Parent or Guardian
Signature of Parent or Guardian

Clear
Photo Consent Form
I, the parent/guardian grant permission and give my consent to Precious Pearls Mentoring for the use of photograph(s) or electronic media images as identified below for organization promotion.
Parents Name
Childs Name

First NameLast Name
Sessions and Special Event Photos

- I understand that I may revoke this authorization at any time by notifying Wallisa Lankford in writing. The revocation will not affect any actions taken before the receipt of this written notification. Images will be stored in a secure location and only authorized staff will have access to them. They will be kept as long as they are relevant and after that time destroyed or archived.
Signature of Parent or Guardian

Clear

Precious Pearls Mentoring Program Rules and Guidelines.

Respect

1. Follow all instructions and directives from staff and mentors.
2. Show respect to fellow participants at all times.
3. Be courteous in your speech to staff, mentors, and participants.
4. Use no profane language.
5. Do not use cell phones unless authorized by staff or mentors.
6. Avoid any threatening behavior, speech, or body language.
7. Do not vandalize or destroy property. Respect the facility.
Trust

1. Keep personal information shared in the program confidential. This is a "safe place" for learning and growth.
2. Share private or sensitive information with a mentor privately.

Safety

1. In our public setting, you must be accompanied by another mentee when using the bathroom. No one goes anywhere alone.

Accountability

Attend regularly and be on time. Sign in upon arrival.
If the program cannot meet on a Saturday, participants and parents/guardians will be notified in advance.

Parents/guardians of minors are responsible for picking up participants after each session or must provide written arrangements for alternate transportation in advance, unless transportation is provided by Ms. Wallisa, or other staff/ Volunteers.

Consequences

Participants who fail to follow these rules will receive a verbal warning. Continued misbehavior may lead to dismissal from the program.
PPM reserves the right to modify these guidelines. Participants and parents/guardians will receive written notification of any changes.

I have read, understood, and accept the rules and guidelines of Precious Pearls Mentoring Organization.
Signature of Participant (Mentee)

Clear
Signature of Parent/Guardian

Clear

The registration fee can be paid using any of the following options:

💵 Cash App: $preciousmentor
💳 PayPal: preciouspearlmentor
💰 Cash: In-person payments are also accepted.

If you have any questions about payment or need assistance, please don’t hesitate to reach out. We're here to help! Contact us at 706-842-9427

Registration is not complete without payment.
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Precious Pearls Mentoring Registration

Monthly dues support the maintenance of our clubhouse and programs. A portion of these dues is allocated for lesson materials, snacks, members-only apparel, and select community events and outings.

*PPM offers payment options for monthly dues*

$50 Annual Enrollment - $25/Monthly Dues Sibling/Family discount available

*Scholarships are provided based on availability and eligibility. **ALL fees are non-refundable*

RELEASE OF LIABILITY FORM

Photo Consent Form

PPM offers payment options for monthly dues