PowerUp Girls for Life Program Registration
Scott Elementary School, Greeley
5TH GRADE PROGRAM
Host partner, Kimberlee Perales
Starts in February. Contact Ms. Perales for the schedule!
AFTER FILLING IN the above FORM AND CLICKING the ORANGE "SUBMIT REGISTRATION" BUTTON:
Please consider making a small donation by clicking the orange “Donate” button to defray our costs and help us serve more girls and develop more programs. No PayPal account needed. Just click the gray "Pay with debit/credit card" button while in PayPal. Thank you very much!
After we receive your form submission, we will notify you by e-mail.
PowerUp Girls for Life Consent Information
By indicating your consent for your child to participate in the PowerUp Girls for Life program while registering online (by clicking to fill the yes button on the registration form consent question), you verify all of the following as required by the program creators and the nonprofit Youth Empowerment Group:
1. You are the parent or guardian of the child registered to participate.
2. You have reviewed the detailed curriculum on this website (click here to review the curriculum), and have no questions or concerns about your child learning about listed topics and other related topics.
3. Your registered child is a 5th grade girl.
4. You understand that this program’s purpose is only educational and not therapeutic. If program facilitators identify a need that may benefit from psychological evaluation or therapy, referral information but not therapy will be given.
5. You understand the following rules for participant conduct that will optimize the learning experience: respectful, non-disruptive behavior, following program facilitator directions, and keeping cellphones on silent and in a pocket or bag. If any of these rules are violated, you will be called to come and pick up your child.
6. You agree that you and your child will follow and comply with your host’s check-in and check-out procedures, which are at their discretion.
7. You, the parent/guardian, will not hold us, the program creators, our nonprofit Youth Empowerment Group company, our volunteers, or any individual affiliated with Youth Empowerment Group or PowerUp Girls for Life program liable for accidents, injuries or other harm related to program participation. You understand that host partners and their venues are not affiliated with Youth Empowerment Group, and you will not hold us or them liable for injuries, accidents, or any other harm related to participation in host partner programs.
8. Your child may be provided food and if she has food insensitivities or allergies, it is her responsibility to ask about ingredients in all food she chooses to ingest, and you have discussed this responsibility with her.
9. You are aware that program facilitators including host partners are mandatory reporters of child abuse and neglect.
10. You permit full, unlimited utilization of photographs or videos of your child taken during her involvement in the program at all program locations for promotional purposes and waive all rights of compensation.
11. One of our goals is to learn how to improve the program and assess how well we provide empowering life-skill education. By consenting, you agree to have your child participate in group verbal surveys and to fill out personal anonymous surveys during the program, indicating things such as understanding of the topics and enjoyment of the activities. You also agree to do a quick anonymous parent-guardian survey after the program. Lastly, you permit us to use summaries of any survey data or anonymous participant quotes in research studies, on our website, or in print materials, etc.