TruthGirlz High School Registration Form

High School TruthGirlz meet once weekly during the school day for up to an hour.  Meeting times and locations vary from school to school.  Registered girls will be notified of their meeting time, locations and any changes to start dates via email. 

  • Parent or Guardian should select the high school that their student attends.
  • Enter parent's number if you do not have a phone.
  • Select the acceptable ways to contact/inform your student
  • Please check all that apply
  • Primary Contact Permission & Information

  • (Parent, Guardian, Care Giver, Custodial Party)
  • Select the acceptable ways to contact/inform Parent or Guardian
  • TruthGirlz Conduct Expectations

  • 1. I will conduct myself according to the standards and expectations outlined in Iredell Statesville Schools Student Handbook particularly the: Network/Internet Acceptable Use Agreement Student Behavior Policies Student Code of conduct (Scripture Reference: 1 Peter 2:13-14; Titus 2:7-8; Romans 13:1)
  • 2. I will neither use my cell phone, laptop or other distractions nor create other distractions during TruthGirlz meetings. (Scripture Reference: 1 Cor 7:35, Col 3:2)
  • 3. I will give others the same respect I would like them to give me. (Scripture Reference: Mark 12:31, 1 Peter 2:17, Matt 7:12)
  • 4. I will be a healthy example to others in how I speak, behave and present myself. (Scripture Reference: Timothy 4:12, Eph 4:29)
  • 5. I will show love to the world around me with actions and truth. (Scripture Reference: 1 John 3:18, Romans 13:10)
  • Please check each box stating that you and your child have read and agree to all requirements for participation in TruthGirlz.
  • Confidentiality Policy of The Pregnancy Resource Center of Statesville

  • The Pregnancy Resource Center of Statesville will hold in strict confidence all the information provided to them except as required by North Carolina State Law or when necessary to protect other or clients against a threat of harm:
  • • In the professional's judgement, they feel the client is likely to do serious harm to themselves or others.
  • • Abuse or neglect of children, elderly or any dependents.
  • • They are ordered by the court to provide information.
  • • The client gives specific written permission.
  • Disclosure Statement

    When disclosure is required, only information that is essential will be revealed. The client will be informed of such disclosure to other agencies.
  • Typing my name acknowledges that I have read, understand and agree with all the above statements.
  • Please check all Permission Statements that you agree with (all are required for you to participate in the TruthGirlz program)
  • I have read, understand and agree with the TruthGirlz Expectations, Response Plan and Confidentiality Policy. Typing my name is my commitment to the TruthGirlz Expectations.