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 MonthJanFebMarAprMayJunJulAugSepOctNovDec

Day Day12345678910111213141516171819202122232425262728293031

Year Year19181919192019211922192319241925192619271928192919301931193219331934193519361937193819391940194119421943194419451946194719481949195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018

School Daughter Attends *

Are you bringing a second daughter for $25?

Yes

No

T-Shirt Size

Youth Large

Adult Small

Adult Medium

Adult Large

Adult Extra Large

2nd Daughter's Information

First Name

Last Name

Birth Date

Month MonthJanFebMarAprMayJunJulAugSepOctNovDec

Day Day12345678910111213141516171819202122232425262728293031

Year Year200420052006200720082009

School Daughter Attends *

Registration Information

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

Girl Scouts

Girls on the Run

Girl Talk

None

Other

How did you hear about the program? * - Select -FriendSchoolGITK NewsletterFlyerFacebookSocial MediaSearch EngineOther

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

Yes

No

Please Check your area of interest

Volunteering

Sponsoring

Programming

Coupon Code

Event(s) * - Select -GITK Empowerment Workshop Series at Studio 1002 Pilates

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.

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