Home
Shop
Henna
Tribal Blog
PMBellyDance
1st Teacher Videos
Regal Rack Resale
Fan Page
Pass Pack Donation
Sister Sites
About Us
HealChillChallenge
Contract
Rites of Passage Institute
Girl's Crescent (age 11-14) Rites of Passage Registration Form
*
Indicates required field
Parent's/Caregiver's Name 1
*
First
Last
Email
*
Parent's/Caregiver's Name 2
*
First
Last
FB Name
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Phone Number
*
Best Way to Reach You
*
Phone
Email
Facebook
Participating Child's Name
*
First
Last
type your daughter's name who will going through the rites of passage
Age of Participating Child
*
Participating Child's Name
*
First
Last
Age of Participating Child
*
Participating Child's Name
*
First
Last
Age of Participating Child
*
Participating Child's Name
*
First
Last
Age of Participating Child
*
Do you have any knowledge or skills you would like to share/contribute to the Rites of Passage
*
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?
*
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.
*
Please list material for possible donation if you like.
*
What do you expect to gain from the Girls' Rites of Passage?
*
What do you and your daughter want to accomplish, what do you expect from us???
Any suggestions, comments, questions, concerns, etc
*
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.
*
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.
*
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
