Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Please acknowledge the following statements by checking each box. EVENT: Trip to Madame Tussauds Wax Museum DATE: Thursday, June 4th, 2026 LOCATION: 234 west 42nd Street in Time Square. Field Trip Permission Statement *I acknowledge that I am granting permission for my child to participate in the field trip listed above as a participant of the Guyanese Girls Rock Foundation Young Women’s Leadership Academy. I understand that my child will be under the supervision of designated academy staff and that all reasonable precautions will be taken to ensure their safety.YWLA Code of Conduct: (copy) *I acknowledge that I have advise my child to follow the YWLA program code of conduct and behave accordingly during this outing and activities.Student Transportation: *I hereby acknowledge that Parents are responsible for providing transportation to and from the pickup location, and that transportation may be via the chaperone’s personal vehicle and/or public transportation.Liabilities: *I release GGRF, and it’s representatives, of all liability of injury or other damage to your daughter, that may result during commute to and from event location, and participation in any of the program activities.Student Name *FirstLastMedical InformationMedical Authorization: *In the event of a medical emergency, I hereby authorize the teacher/chaperone attending to my daughter on the trip to secure medical attention or hospitalization for my child.Doctor's Name: *FirstLastDoctor's Phone: *SignatureParent Name: *FirstLastPhone: *Email Address: *Parent Signature: * Clear Signature By signing and submitting this Application, I certify that the above information is correct and complete. Please use your mouse (or finger on mobile devices) to create signature. Name *FirstLastPlease prove you are human by selecting the house:Submit
