Chicago Registration Form

1 Start 2 Payment 3 Complete

Trusted Adult Information

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip *

Email *

Home Phone *

Mobile Phone

Would you like to receive text message updates at this number?

Yes

Employer

Job Title

Pre-Teen Girl Information

First Name *

Last Name *

Birth Date *

Month

Day

Year

School Daughter Attends *

Are you bringing a second daughter for $25?

Yes

2nd Daughter's Information

First Name

Last Name

Birth Date

Month

Day

Year

School Daughter Attends *

Registration Information

Do your daughters belong to any of the following organizations? *

How did you hear about the program? *

I'm interested in learning more about volunteering as a Program Leader in return for reduced fees* *

Yes

Please Check your area of interest

Volunteering

Sponsoring

Programming

Coupon Code

Event(s) *

In order to confirm your registrations do you agree to our terms, conditions and refund policy? * *

Yes, I have read and agree to the above terms of use.