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Rites of Passage Institute
Girl's Crescent (age 11-14) Rites of Passage Registration Form
*
Indicates required field
Parent's/Caregiver's Name 1
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First
Last
Email
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Parent's/Caregiver's Name 2
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First
Last
FB Name
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Phone Number
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Best Way to Reach You
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Phone
Email
Facebook
Participating Child's Name
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First
Last
type your daughter's name who will going through the rites of passage
Age of Participating Child
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Participating Child's Name
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First
Last
Age of Participating Child
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Participating Child's Name
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First
Last
Age of Participating Child
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Participating Child's Name
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First
Last
Age of Participating Child
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Do you have any knowledge or skills you would like to share/contribute to the Rites of Passage
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Yes
No
Maybe
Any information or skills you want to teach the girls or facilitators.
Would you like to donate any material for the Rites of Passage?
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Yes
No
Maybe
paper, plastic letters, glue, paint, chalk, magnets, contact paper, small baby plastic pool, etc
Please list names of any possible volunteers, useful connections, or resources.
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Please list material for possible donation if you like.
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What do you expect to gain from the Girls' Rites of Passage?
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What do you and your daughter want to accomplish, what do you expect from us???
Any suggestions, comments, questions, concerns, etc
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I understand that when a child is going through a Rites of Passage the parents are going through a rites of passage too. Therefore, I understand that this program requires my full participation.This is not a drop off activity. I expect to be present at all meetings.
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Yes, I agree.
No, I do not agree.
I'm aware that I may be exposed to information concerning individuals that is of a personal and confidential nature. I agree that this information will not be disclosed to any third party.
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I Agree
I do not agree
Confidentiality Agreement.What happens between the participants stays between the participants within the Rites of Passage Program.
Submit
TELEPHONE NUMBER
1-877-570-3108
