2026 Girl, Let’s Talk About Periods (GLTAP) Summer Camp Registration

2026 Girl, Let’s Talk About Periods (GLTAP) Summer Camp Registration

The PUPA Project proudly presents our 4th Annual Girl, Let’s Talk About Periods Summer Camp, a safe, structured, and educational experience for girls navigating puberty and menstrual health. Participants will engage in age-appropriate sessions focused on hygiene, menstrual education, confidence-building, and self-advocacy, led by trusted community leaders and professionals. Please complete this form in full. Registration is not complete until registration payment is submitted.
Camp Information
Camp Dates: June 15th - June 19th, 2026

Time: 8:00 AM - 2:00 PM

Location: 655 Beasley Rd, Jackson, MS 39206

Camper Full Legal Name*

First NameLast Name
Preferred Name (if different)
Date of Birth*

MonthDayYear
Date
Age (will be calculated automatically from Date of Birth)*
Grade (Fall 2026)*
School
City*
County*
Parent/Guardian Full Name*

First NameLast Name
Relationship to Camper*
Primary Phone*
Please enter a valid phone number.Format: (000) 000-0000.
Secondary Phone (optional)*
Please enter a valid phone number.Format: (000) 000-0000.
Email Address*
example@example.com
Home Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code

Emergency Contact & Pick-Up
Name*

First NameLast Name
Relationship*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Authorized Pick-Up List

All individuals must present a valid government-issued ID at pick-up. If someone not listed will pick up your child, you must notify us in advance. No exceptions will be made for safety reasons. Please list ALL individuals authorized to pick up your child, including yourself.
Authorized Person #1:*

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Authorized Person #2: *

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Authorized Person #3:*

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.

Medical & Health Information
YesNo
If yes, please explain
YesNo
If yes, please explain
YesNo
If yes, please explain
YesNo
If yes, please explain

Medication Authorization
YesNo
If Yes, Please List (Medication Name, Dosage, Frequency, Reason for Medication, Method of Administration, Storage Instructions, and Special Instructions)

Camp Participation & Permissions

Participation & Program Consent (All Required for Checkboxes)
I give permission for my child to participate in all camp activities.I give permission for my child to receive menstrual products during camp.I give permission for my child to receive hygiene products.I give permission for my child to receive educational materials to take home.
Media Release

Media Release Consent
I give permission for my child to be photographed and/or recorded for educational and promotional use by The PUPA Project.I do NOT give permission.
LIABILITY WAIVER & EMERGENCY AUTHORIZATION

Liability & Emergency Authorization
Participation in camp activities may include physical, social, and educational experiences. I understand that participation may involve risk of minor injury, illness, allergic reactions, or loss of personal property.I release and hold harmless The PUPA Project, its staff, volunteers, and partners from any and all liability arising from participation in this camp.*

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In the event of an emergency, I authorize The PUPA Project to seek medical treatment for my child if I cannot be reached.*

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I have read and agree to the liability waiver and emergency authorization.*

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Code of Conduct

Camper Code of Conduct
Campers are expected to:
- Treat others with respect
- Follow staff instructions
- Use appropriate language and behavior
- Stay within assigned areas
- Participate in activities
Failure to follow expectations may result in parent notification or dismissal.
I understand and agree to the camper code of conduct.*

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Camper Details & Preferences

Additional Information
T-Shirt Size*
How did you hear about this camp?
Is there any additional information you would like to share with us?

Registration Fee & Payment*

Summer Camp Registration Fee

Registration for Girl, Let’s Talk About Periods Summer Camp 2026. Required to complete registration. Please note that this is a NON-REFUNDABLE fee.

$30.00

Enter coupon

Total

$0.00

Credit Card

I understand registration is not complete until payment is submitted.
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2026 Girl, Let’s Talk About Periods (GLTAP) Summer Camp Registration

Camp Information

Emergency Contact & Pick-Up

Authorized Pick-Up List

Medical & Health Information

Medication Authorization

Camp Participation & Permissions

Media Release

LIABILITY WAIVER & EMERGENCY AUTHORIZATION

Code of Conduct

Camper Details & Preferences

Credit Card