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7 Habits Series: REGISTRATION DEADLINE: Friday, January 10, 2014 (Space is limited)
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7 Habits Series: REGISTRATION DEADLINE: Friday, January 10, 2014 (Space is limited)

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REGISTRATION DEADLINE: Friday, January 10, 2014 (Space is limited)

REGISTRATION DEADLINE: Friday, January 10, 2014 (Space is limited)

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  • 1. 7 Habits for Highly Effective Families/Adults Registration REGISTRATION DEADLINE: Friday, January 10, 2014 (Space is limited) **Please complete one registration per family or one per person; teen registration is a separate form** Dates: 4 sessions; Tuesday’s-January 21, 28; February 4, 11, 2014 Name(s): __________________________________________________________ Number Attending: _________ Family member’s service information: Service Branch Component Deployment Status □ □ □ □ □ □ Active Duty □ National Guard □ Reserves □ Currently deployed □ Recently returned □ Deployment pending Air Force Army Coast Guard Navy Marines □ Department of Defense Employee Contact Numbers: ___________________________ __________________________ Cell Number Back-up Emergency Number Email Address: ______________________________________ PHOTO/PRESS RELEASE: I understand the Georgia National Guard Joint & Family Services is developing photographic and multimedia materials, which will illustrate events occurring throughout the year for the program. I grant the Georgia National Guard Joint & Family Services and its associated staff and subordinate entities the right to take, use, reproduce, assign and/or distribute photographs, films, non-confidential information, videotapes and sound recordings of the program participants, for use in any such materials as the National Guard Joint & Family Services or its associated entities may create, without any payment to or future approval by me. I concur that there shall be no payment for such use. ____________________________ Parent or Legal Guardian Signature _____________ Date **Please send completed registration form(s) no later than Friday, January 10, 2014 to kara.b.coleman2.nfg@mail.mil**
  • 2. 7 Habits for Highly Effective Teens Registration REGISTRATION DEADLINE: Friday, January 10, 2014 (Space is limited) **Please complete one registration per person** Dates: 4 sessions; Tuesday’s-January 21, 28; February 4, 11, 2014 Teen Name: __________________________ Date of Birth: _____________Age:____ Parent/Guardian Name: _________________________________________________ Contact Numbers: ___________________________ __________________________ Cell Number Back-up Emergency Number Email Address: ______________________________________ Gender M _____ F _____ PHOTO/PRESS RELEASE: I understand the Georgia National Guard Youth Program is developing photographic and multimedia materials, which will illustrate events occurring throughout the year for the Youth Program. I grant the National Guard Youth Program and its associated staff and subordinate entities the right to take, use, reproduce, assign and/or distribute photographs, films, non-confidential information, videotapes and sound recordings of the Georgia National Guard Youth Program participants, for use in any such materials as the National Guard Youth Program or its associated entities may create, without any payment to or future approval by me. I concur that there shall be no payment for such use. ____________________________ Parent or Legal Guardian Signature _____________ Date **Please send completed registration form(s) no later than Friday, January 10, 2014 to kara.b.coleman2.nfg@mail.mil**