Registration and Waiver

Please fill out the registration form and waiver for the retreat below. This can be scanned and/or emailed back to: 

beautifulyoubracelets@gmail.com

or mailed to:

The Pemi Youth Center
c/o Got Beauty?
111 Main Street
Plymouth NH
0346.

ANY QUESTIONS? Email us at beautifulyoubracelets@gmail.com

got beauty?

The Empowerment Retreat: Presented by The Pemi Youth Center and The BEA[YOU]TIFUL Project

Saturday June 7, 2014

CHECK IN TIME: 8:30-9:00AM

PICK UP TIME: 6:00 PM

 at the Pemi Youth Center, 111 Main Street Plymouth, New Hampshire

REGISTRATION FORM

Full name_____________________________________________

Age____ Date of Birth ____/____/_____

Parent/Guardian full name______________________________________

Full Address ______________________________________________________________________________________________________

Tel. # Home ____________________________

Work __________________________

Cell/Other _________________________________

E-mail:___________________________________

T-Shirt Size: ______________________________

Person to notify in emergency ___________________________________________________

Tel # ________________________________

Participant’s health insurance company_______________________________

Participant’s doctor's name_________________________________________

Player's doctor Tel.______________________________________

Medical Concerns/Allergies of Participant (if none please write none, if yes please describe) _________________________________________________________________________________________________________________

Any Additional Concerns

got beauty?

The Empowerment Retreat: Presented by The Pemi Youth Center and The BEA[YOU]TIFUL Project

Saturday June 7, 2014

CHECK IN TIME: 8:30-9:00AM

PICK UP TIME: 6:00 PM

 at the Pemi Youth Center, 111 Main Street Plymouth, New Hampshire

WAIVER / INDEMNIFICATION

Parent(s) or legal guardian must sign below before the participant is accepted to participate in the “got Beauty Empowerment Retreat” to be held at the Pemi Youth Center at 111 Main Street Plymouth, New Hampshire on Saturday June 7, 2014 (the “Retreat”): As parent/legal guardian of the child named herein, I hereby represent that the child has been examined by a pediatrician and is physically fit to participate in the Retreat at the Pemi Youth Center. I hereby accept all responsibility for and agree to pay any and all costs of medical treatment resulting from any injury suffered by my child as a result of his/her participation in the Retreat. I further agree to indemnify and hold harmless the Pemi Youth Center, the BEA[YO]TIFUL Project, and their respective directors, officers, employees, agents and representatives, from any and all liability, damage, or expense arising out of my child’s participation in the Retreat.

In the event that I cannot be reached in an emergency, I hereby give permission for a qualified Pemi Youth Center staff member, an emergency medical technician, a physician or staff member at a hospital, or any other qualified individual to administer care and provide any medical treatment deemed necessary for my child.

Signature of parent(s) or legal guardian:

_______________________________________________________________________

Date: ________________

THANK YOU FOR YOUR INTEREST!

HELLO AND THANK YOU FOR YOUR INTEREST IN THE GOT BEAUTY? RETREAT!

Got Beauty? is a one day retreat which will be held on Saturday June 7th 2014 in Plymouth New Hampshire at The Pemi Youth Center. This retreat is a combination of the efforts of The Pemi Youth Center and The BEA[YOU]TIFUL Project.

The Pemi Youth Center is a youth center located at 111 Main Street in Plymouth New Hampshire. The Pemi Youth center serves as a safe and caring place for youth to go after school, on weekends and during school vacations. The programming the Pemi Youth Center provides enables these youth to develop their abilities, talents and interests.The mission is to provide a safe and welcoming environment outside of school and gain a sense of community, belonging and self esteem.

This retreat specifically will be presented in part by the S.E.L.F program at the Pemi Youth Center. S.E.L.F is a regular group held at the Pemi Youth Center. The mission of this group being one to bring support, awareness, confidence, empowerment and self-love through self-discovery.

Along with The Pemi Youth Center, The BEA[YOU[TIFUL Project will be co-leading the retreat. The BEA[YOU]TIFUL Project is a project dedicated to convincing every woman to embrace the meaning of true beauty while simultaneously raising money for the National Eating Disorders Association through bracelet sales. All of the bracelets are handmade, from the heart and named after those who inspire the sisters. The BEA[YOU]TIFUL Project also produces originals videos as part of the BEA[YOU]TIFUL movement, a youtube channel focusing on  true  beauty and inspiration.

The retreat specifically will be presented in part by the emPOWERment branch of The BEA[YOU]TIFUL Project, the piece of the project which focuses on education and youth retreats.

The retreat will be held on Saturday June 7th 2014. for girls 10-18. The day will be filled with workshops, speakers, a panel discussion, meditation and all three meals will be provided. The registration form and full schedule are available through the next posts. A $5 donation is suggested.

Any questions, PLEASE FEEL FREE TO CONTACT US! beautifulyoubracelets@gmail.com