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Who We Are
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Frequent Questions
Location
YWCA Board Members
YWCA Staff
Partners of YWCA Lincoln
Vision
Programs & Services
Introduction
CATCH
Circle of Security
Girls Circle
Job Outfitters
Project Restore
SMART Girls Club
About
Why is SMART Girls Club Important?
Virtual SMART Girls Club
SMART Girls Unite! Event 2021
Volunteer
Sign up to receive more information
Resources for the Girls!
Partners in the Community
Take A Break
About
Take A Break Volunteer Form
Client Intake Form
Emergency Contact Form
Release and Permission Form
What You Can Do
Overview
Become a Member
Donate
Volunteer Opportunities
Volunteer Opportunities
Smart Girls Club Volunteer
News & Publications
Newsroom
Publications & Resources
Activities and Events Calendar
Donate
Introduction
CATCH
Circle of Security
Girls Circle
Job Outfitters
Project Restore
SMART Girls Club
About
Why is SMART Girls Club Important?
Virtual SMART Girls Club
SMART Girls Unite! Event 2021
Volunteer
Sign up to receive more information
Resources for the Girls!
Partners in the Community
Take A Break
About
Take A Break Volunteer Form
Client Intake Form
Emergency Contact Form
Release and Permission Form
Release and Permission Form
Please read the following and check yes or no.
I give permission for my child to participate in Take a Break.
Yes
No
I agree to read the parent manual and support the policies stated in it to the best of my ability.
Yes
No
In the event that my child is injured I give permissionforTake a Break staff to call a physician, ambulance or dentist to treat my child, if necessary. I understand that a concentrated effort will be made to contact me, another guardian or emergency contact. I understand that we and not the YWCA Lincoln will accept this expense.
Yes
No
I give permission for my child to attend field trips with TAB program that would include walking in the community.
Yes
No
I give permission for my child's, my families, and my own image to be used in pictures, digital images, and video for the purposes of promoting the TAKE A Break Program on social media, grant information, or other uses deemed necessary by YWCA of Lincoln and partnering organizations.
Yes
No
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Parent Name
First Name
Last Name
Child/Children’s Name(s): (Required)
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