She Can PA Day Workshop - October 10
Session Name
If no sessions are appearing, all programs are fully sold out.
Registration Closed
Yes
No
Session at Capacity
Yes
No
Session Information
For Girls in Grades
Session Start Date
Time
Duration
Location
Address
Session Details
October 10th | Grades 4 - 6 | 2:00pm - 3:30pm
Session ID
Child Information
Child's First Name
Child's Last Name
School Child Currently Attends
Grade
Please select...
4
5
6
Birthdate (mm/dd/yy)
Parent/Guardian Information
Parent/Guardian First Name
Parent/Guardian Last Name
Phone Number
Email Address
Street Address
Town/City
Postal Code
Secondary Contact
Secondary Contact First Name:
Who should we call if we can't reach you?
Secondary Contact
Last Name:
Secondary Contact
Phone Number:
Must be different from parent phone number listed above.
Relationship to child
Please select...
Parent/Guardian
Friend
Aunt
Uncle
Grandparent
Participant Medical Information
Does your participant have any medical conditions, allergies or medications we should know about?
Yes
No
Please provide additional medical information (including if your child has a puffer or epi-pen)
I understand that the She Can! Girls Empowerment Programs are for girls (inclusive of cisgender and transgender girls) and nonbinary youth.
I
grant MCRC permission to use photos of my participant on their social media accounts, website, and on promotional materials. (Optional)
If I am late picking up my child, a $5.00 for every 15 minutes may apply
I
would like to be added to the She Can! Email Mailing list. (Optional)
Would you like to make a donation to support She Can! Girls Empowerment programs?
No
Yes
Please Note: This She Can! program is 100% free to attend and a donation is
not required
to participate.
Donations
She Can! programs rely on grants, fundraising and donations to continue this important work. Making a donation today would enable us to continue to provide the much needed program supplies to girls in our community for our upcoming programs.
Click here to make a She Can! donation!
Email Details
Notice
This session is now full, thank you for your interest.
Notice
We'll now be collecting demographic information once a year—stay tuned for more soon!
Contact Information