Glowin’ Within Parent Enrollment Form

Thank you for enrolling your teen into our Glowin’ Within Workshop! We can’t wait to share this experience with so many brilliant girls who are committed to being the best version of themselves!

First Name

Last Name

Cell Phone Number

Email Address

Your Teen's Name

Who referred you to Glowin' Within?

What inspired you to enroll your teen into Glowin' Within?

What do you think your teen's biggest strengths are?

What do you think their greatest areas of improvement are?

What do you want your teen to gain from this experience?

If there is anything you would like us to know about your teen, please share below.

On a scale of 1-10 with 1 being the lowest and 10 being the highest, what would you rate your relationship with your teen, and why?

Do you know anybody over 18 who would like to volunteer at the event?

Yes No

Tuition Options

Please note: You will be redirected to payment options upon submission of this form.

*This is a referral-based program. If you know any teens who would be interested in Glowin’ Within, you will receive a $20 credit towards your tuition for each referral*

Things to Note:

Please be sure your teen wears comfortable fitness clothing that they can easily move around in. Make sure they also bring a water bottle, favorite childhood photo, notebook and pen.

On Saturday, June 10th, lunch will be provided. On Sunday, June 11th, teens will bring their favorite healthy meal and snacks, and we will have a potluck!

Please check your e-mail for further information regarding workshop preparation.

We can’t wait to see your teen unleash their inner power and tap into their brilliance!

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