Online Registration for PBG Academy

Online Registration for PBG Academy

Pretty Brown Girl is dedicated to empowering Black and Brown girls in grades K-12. You are receiving this form because your student has an opportunity to participate in our virtual program, Pretty Brown Girl Academy.

Before completing this form, you must review and accept our Terms and Conditions here. If you have any questions as you complete the registration process, please contact PBG Representative, LaTonya Reese, via email at lwalton@prettybrowngirl.com.

Thank you and we look forward to having your Pretty Brown Girl(s) participate with us this school year!

Parent/Guardian Information

Parent/ Guardian Name *

First

Last

Parent/ Guardian Email Address *

Parent/ Guardian Phone Number *

Your Relationship To Student *

If other, please share

Student Information

Student Name *

First

Last

Student Date of Birth *

Student Home Address *

Address Line 1

Address Line 2

City

State

Zip Code

Student Phone Number (if applicable)

Student Email Address (if applicable)

Student Grade Level *

What school does student attend? *

Student T-Shirt Size *

Please note that one complimentary T-Shirt will be provided for the student. Please review the sizing chart here to ensure the right size is selected before submitting this form.

Please tell us why you want to join Pretty Brown Girl Academy *

Did you review the sizing chart before selecting the Student's T-Shirt size? *

Do you agree to our Terms and Conditions? *

I accept Terms and Conditions

Do we have your consent for the student to participate in our virtual programming? **The platforms that Pretty Brown Girl will be utilizing include but are not limited to: Zoom, Microsoft Teams and Google Meet. Please review their respective terms and conditions. *

Yes, my child has permission to participate in Pretty Brown Girl's virtual programming
No, my child does not have permission to participate in Pretty Brown Girl's virtual programming

Website

1-800-514-8559

info@prettybrowngirl.com

1-800-514-8559

info@prettybrowngirl.com