AN IMAGE OF ME (AIM)

PARTICIPANT APPLICATION

Parent/Guardian Information

Participant’s Information

Additional Information

Emergency Contact Information

LIABILITY AND RELEASE FORMS

AIM LIABILITY FORM

An Image of Me (AIM) provides mentoring, personal development, leadershiptraining, and community-based activities for girls. AIM is committed to maintaining a safe, supportive, and structured environment.

Assumption of Risk

I understand that participation in An Image of me programs, events, workshops, and activities may involve physical, emotional, or social interaction. While AIM takes reasonable ste0ps to ensure safety. I acknowledge that risks may include, but are not limited to:

• Minor injuries (scrapes, fails, bumps0

• Emotional discomfort during discussions or activities

• Risk associated with transportation to and from events

• Unforeseen incidents that may occur during group activities.

I voluntarily assume all risks associated with my child's participation.

CODE OF CONDUCT RELEASE FORM

An Image of Me Code of Conduct is built on respect, kindness, integrity, and emotional safety. Every participaht is expectedto honor herself and her sisters through positive behavior, healthy communication and accountability.

Key Expectations

• Respect Every Sister: Honor each girl's voice, boundaries, and individuality.

• Speak Life: Use uplifting, encouraging language, avoid gossip, bullying or harmful comments.

• Protect Emotional Safety: Maintain confidentiality and create a judgment free environment.

• Practice Accountability: Own mistakes, repair harm, and choose growth.

• Engage Fully: Partiipants listen actively, and contribute positively to the sisterhood experience.

Safety Standards

• Zero tolerance for bullying, harassment, discrimination, or exclusion.

• Respect personal space and physical boundaries.

• Maintain appropriate behavior in person and online.

• Follow all program rules to ensure a safe substance-free environment.

Community Committee

Every AIM girl agrees to uphold the values of intentional sisterhood--supporting one another celebrating differences, and representing the program with pride, kindness and leadership.

Purpose of the Code

The Code of Conduct protects the heart of AIM, creating a space where girls feel seen, valued, and safe, allowing them to grow into confident, compassionate leaders.

MEDIA RELEASE FORM

An Image of me uses interviews and photographs of participants for media campaigns, public information and education purposes, brochures and our website.

I understand that An Image of Me shall not be liable for royalties, commissions or payments of any nature to me or my daughter in connection with such filming, photographing, and interviews. An Image of Me assumes no liability of any nature in connection with such filming or interviewing.

MEDICAL RELEASE FORM

I give permission for my daughter to participate in An Image of Me activities. In case of an emergency, I understand that An Image of Me will make every effort to contact me. In the event that I cannot be reached, I hearby authorize An Image of Me to secure proper medical attention, including hospitalization, and ambulance transportation, if needed.

I understand that An Image of Me will not administer medication, but will hold any medication with staff when needed. It is my daughter's responsibility to inform the staff when she needs to take her medication during An Image of Me meetings, field trips, or excursions.