TruthGirlz Middle School Registration Form – Registration is OPEN for FALL.

Most middle school TruthGirlz will meet immediately after school.  BGCP girls will meet at 4:30.  End times vary.  Select your site in the form below for your meeting day and start date.  Please contact Christina Lovelace or Carrie Jenkins at our office (704)871-0338 with any questions.

  • For meeting site, select the middle school that the student attends UNLESS the girl will attend meetings at the Boys & Girls Club of the Piedmont. In this case, select BGCP as meeting site.
  • 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)
  • 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 defendants.
  • • 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.
  • Please check each box stating that you and your child have read and agree to all requirements for participation in TruthGirlz.
  • 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 in this box is my commitment to the TruthGirlz Expectations.
  • Alternate Contact Information

  • (the next person to call if the Primary Contact cannot be reached)