Partners of BGirlz Academy

BGirlz Production Application

Give your child(ren) the opportunity of participating in a BGirlz Academy production! The parent/guardian may fill out the application below to proceed:

  • Parent/Guardian & Child(ren) Details

  • Type your child's name in the field. Click the + button to add more fields to add more children's names.
    First NameLast NameAgeBirth Date 
  • Check all that apply.
  • Legal Consent For Child(ren) to Attend Events

  • By clicking the box AND signing below, I give permission to the following: For my child to participate in BGirlz Academy. 

    I certify that all the information on this form is true and correct.

    In the event of an emergency, I understand that every effort will be made to contact me or my emergency contact (s).

    I understand in emergencies requiring immediate medical attention, my child will be taken to the nearest hospital emergency room. My signature authorizes the responsible person at the Academy to have my child transported to the hospital.

    I release the organization and its employees, agents, members, volunteers, and all other persons on its behalf from all liability for any damage or injury which such child might sustain while participating in program and activities, including but not limited to any liability to any right of action that may occur to such child directly, or to me as his/her guardian.

    Consent to Release Media Footage (please check one): I grant permission to recognized broadcast media and to BGirlz Academy to record footage of my child. This footage may be aired during upcoming newscasts and/or used for recruitment purposes for BGirlz Academy.

    Consent to Release Photographs and Video footage (please check one): I grant permission to BGirlz Academy to use photographs and video footage of my child, which may be used in printed materials (e.g., brochures, newspapers) and/or on BGirlz Academy websites, or otherwise used for recruitment purposes for BGirlz Academy.

  • This field is for validation purposes and should be left unchanged.