GLW Commitment Form

We encourage GLW Participants to complete this Commitment Form ONLINE.

If you wish to print, sign, and send this document to ERVK in hard copy, please download the form below and post to ERVK no later than Friday, May 11, 2018.


This commitment form serves as a record of my agreement to participate in Girls’ Leadership Worldwide (GLW) 2018 at the Eleanor Roosevelt Center at Val-Kill (ERVK) in Hyde Park, New York.

Session I: July 7-15, 2018
Session II: July 21-29, 2018

The program requires that I sleep away from home for eight nights and nine days in a supervised school/college dormitory where I will live and work with young women from diverse backgrounds, participate in workshops and activities (some which involve physical exertion), make public presentations, and conduct myself responsibly while participating in the 2018 GLW program. At all times, I will serve as a proud representative of my school, community, and the Eleanor Roosevelt Center at Val-Kill.

I understand that the success of the program depends on both my active participation and enthusiasm in all discussions and activities. I look forward to hearing and offering differing points of view and agree to respect the experience and expertise that the presenters and other participants bring to GLW.

I agree to adhere by all program rules, including no smoking, alcohol or drug use, or violence of any kind. I understand that I will not be permitted to leave the school/college campus or ERVK for any reason unrelated to GLW. I understand that when I leave the campus or ERVK as part of the GLW program, a Group Leader or another responsible adult must accompany me at all times. I further agree to be on time for all activities, including occasional day trips that begin at 6:00am in the morning. Additionally, I agree to all of the following: to perform all assigned clean-up duties, to adhere by dormitory curfews, to respect the privacy and property of other participants, and to respect the authority of the Group Leaders, Dorm Director, GLW Program Manager, GLW Program Assistant, and the ERVK staff.

My signature on this commitment form and that of my legal guardian(s) demonstrate our commitment to my active participation in all program activities and my commitment to adhere by the program rules and regulations. Any violation of these rules and regulations may result in my early removal from the program, with my legal guardian(s) being responsible for the cost and arrangement of my early departure.

I understand that I am expected to pay the $2,500 program fee, which will cover my expenses while participating in GLW (unless I have been awarded tuition assistance by ERVK). I also understand that I will provide my own transportation to and from the program in Hyde Park, NY. Furthermore, I recognize that I am responsible for providing my personal spending money for souvenirs and any additional items I wish to purchase during my participation in the GLW program.

I understand that if ERVK does not receive the following information within the appropriate DEADLINES listed below, I may forfeit my space in the program:

  • Friday, May 11, 2018 – Signed Commitment Form
  • Friday, May 18, 2018 – $200 Non-refundable Deposit, Details Form, Interest Survey
  • Friday, June 1, 2018 – Completed Medical and Release Form
  • Friday, June 8, 2018 – Tuition Balance

We acknowledge that we have read this commitment form and understand and commit to everything stated above.

ATTENTION: You may pay your Tuition Balance along with your $200 Non-Refundable Deposit in one transaction on the “GLW Payment or Donation” page after clicking ‘SUBMIT’

Eleanor Roosevelt: Universal Declaration of Human Rights

Article 5 No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment.