Registration

The Brightest Star in the Sky
Girl Conference Registration
Please return to your teacher by Friday, March 1, 2013

Name:_____________________________________________________
Address: ____________________________  Grade: __________________
Phone Number: _________________ School: ________________________
Allergies: ___________________________________________________
Number from 1 to 14, in order of preference, the activities you want to attend. 1 is the session you definitely want to see and 14 is of little interest to you.

______Self-Care– Self-Defense
______ Beauty on the Outside – Make-up
______ Let’s Keep it Clean – Smell Pretty, Look Pretty
______ Shake Your Groove Thing – Exercise and Dance
______ Finger Feasts – Making Finger Foods
______ Money, Money, Money – Taking Care of Business
______ Beauty on the Inside – Building Healthy Relationships
_______ Everyone Else is Doing it – The Effects of Drugs & Alcohol
_______What’s the Big Deal about Cutting?
_______ Getting What You Want: The Art of Positive Communication
_______ Dear Diary – The Art of Journaling
_______ I am Beautiful – Body Image
_______ You Are What You Eat
_______ That’s What it Looks Like on TV – Media and Feeling Good


I would like to attend the sessions with my group of friends. My friends are:

1. _________________________________________________
2. _________________________________________________
3. _________________________________________________
4. _________________________________________________
5. _________________________________________________
I am okay traveling by myself. 
Parent Signature:

My daughter, _________________________, has my permission to attend the conference for girls at Harris Middle School on March 23, 2013 from 8:30A.M. - 2:30 P.M.
___________________________________
Signature
I give permission for my daughter, ________________, to receive free tampon samples.
___________________________________
Signature

I give permission for my daughter, ___________________, to be photographed for the newspaper and/or the internet to share the conference experience.
____________________________________
Signature
If you have questions or concerns, please contact:
Nancy Weatherhead at weatherheadn@bedfordk12tn.net   Sherry Lawell at lawells@bedfordk12tn.net
Claudia House at housec@bedfordk12tn.net     Kim Dolan at dolank@bedfordk12tn.net
Kelli Dodson at dodsonk@bedfordk12tn.net    Toni Canonico at canonicot@bedfordk12tn.net

Sponsored by: Duck River Electric, United Health Care
Lunch and Snacks provided by local churches