Jabberwock Handbook - Durham Alumnae Chapter Delta Sigma Theta Sorority, Inc. Presents
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Durham Alumnae Chapter
Delta Sigma Theta Sorority, Inc.
Presents
Jabberwock Handbook
Table of Contents
TABLE OF CONTENTS ............................................................................................................................................................................. 2
PROGRAM OVERVIEW………….…………………………………………………………………………………………………………………………………………………………….3
CONTRIBUTIONS & PATRONS ................................................................................................................................................................ 6
ADVERTISEMENTS ................................................................................................................................................................................. 7
OTHER FUNDRAISING EVENTS ............................................................................................................................................................... 7
RECEIPT PERCENTAGES……………………………………………………………………………………………………………………………………………………………………….7
ADVERTISING CONTRACT……………………………………………………………………………………………………………………………………………………………………8
TIPS FOR SUCCESS………………………………………………………………………………………………………………………………………………………………………………9
COLLECTION OF FUNDS ....................................................................................................................................................................... 10
FUNDRAISING SUGGESTIONS ............................................................................................................................................................. 11
PROPOSED TIMELINE .......................................................................................................................................................................... 14
APPLICATION PACKET INFORMATION ................................................................................................................................................. 17
YOUTH CODE OF CONDUCT………………………………………………………………………………………………………………………………………………………………18
PARTICIPANT PROFILES………………………………………………………………………………………………………………………………………………………………….…20
PARTICIPANT/PARENT/GUARDIAN CONSENT FORM…………………………………………………………………………………………………………………………23
PARENTAL/GUARDIAN AFFIRMATION………………………………………………………………………………………………………………………………………………25
WAIVER AND RELEASE………………………..…………………………………………………………………………………………………………………………………………..25
ADDITIONAL REQUIRED FORMS………………………………………………………………………………………………………………………………………..……………..26
2
Jabberwock Handbook
Program Overview
**Please note: Details are subject to change due to the pandemic, as we must
follow current protection protocols and contactless guidelines.**
Parents/Guardians
Jabberwock is a national program within Delta Sigma Theta Sorority, Inc. that reflects
the Sorority's commitment to scholarship and the arts. Proceeds from Jabberwock activities and
fundraisers are used to provide college scholarships for young women and men, as well as provide
service to the community.
Jabberwock is designed to be competitive, fun, and hard work but ultimately, a very
rewarding and enriching experience for the participants and their loved ones. It requires the full
support and involvement of parents, family, guardians, friends and the community.
Each participant must have approval of a parent or guardian to participate in Jabberwock.
While expectations are that participants make a commitment to the program, it is also the
responsibility of the parent(s) or guardian(s) to ensure that the participant abides by all Jabberwock
guidelines. This will ensure that our Jabberwock participants receive the maximum benefits of the
Jabberwock experience as intended.
Participants
Jabberwock participants are young ladies who are rising juniors or seniors. All
participants are expected to engage in all Jabberwock social, educational, community service and
fundraising activities, as well as the Jabberwock Gala. We also expect to be notified in advance
about issues and/or conflicts in your schedule that interfere with your full participation.
Young ladies who have participated in a previous Durham Alumnae Chapter Jabberwock
Gala are not eligible to participate again. We will only present a young lady to society once.
Occasionally, young ladies will begin the program and then will have to withdraw before the
Gala. In this case, she is eligible to participate in a future year (as long as she is still in high
school). However, she will be required to complete the full application process again.
Activities
Jabberwock is a fun and enriching program. Part of the fun are the activities leading up
to the Jabberwock Gala. These vary from year to year, but have typically included outings such
as teas, cookouts, participation in a local college homecoming parade and active participation in
public service activities. Our Jabberwock program also includes self-improvement activities
such as health awareness, career development and social graces. Each participant is expected to
attend these activities and take full advantage of the Jabberwock experience.
3
Scholarships
Jabberwock is a scholarship program. Jabberwock scholarships are awarded to each
participant based on the amount of funds raised by that participant. Funds will be distributed to the
participant in the weeks following her high school graduation. If a participant should withdraw
from the program early (before the Gala), she will forfeit her scholarship earnings.
Fundraising
Jabberwock is also a fundraising event. In order to be successful in this area of the
program, each participant is encouraged to raise funds through the solicitation of general
contributions, as well as family and other organized fundraising events that will contribute to
your success. Solicitation letters and brochures may be used to announce your intention to
participate and raise funds, but final drafts of each MUST be approved by the Chapter President
and Jabberwock Chairs before they are distributed. While you can list immediate family
members on your brochure, you may NOT list team member’s or fundraising partner’s names
on any letters or brochures.
Electronic fundraising formats (i.e. Go Fund Me) are allowed, but the Chapter President and
Jabberwock Chair must approve your page before it is launched. You may also utilize social media
(i.e. FaceBook and Instagram) to announce and post fundraisers or flyers, but flyers and
announcements must be approved the Chapter President and Jabberwock Chairs before they are
posted. Failure to secure prior approval will result in having to remove your page and
prohibiting any future postings on any social media format.
General contributors of $25 or more will be featured in the Jabberwock Souvenir Journal.
There will be a specific process and schedule for the submission of patron lists and funds collected
by the participant. It is important that each participant adhere to the process and all deadlines
to insure accurate recording of funds raised and patron listings.
Group fundraisers
Participants must actively participate in group fundraisers and solicit contributions/funds
toward group fundraiser activities to receive proceeds from the collected funds.
Participants who solicit funds in the name of the Jabberwock program and later withdraws
from the competition for any reason must submit all solicited funds to the Sorority. Any funds
received after the deadline date must be submitted to the Sorority.
All participants will be notified early in the program of the final reporting period for
fundraising. The participant who raises the largest amount of money by the end of the
Jabberwock official reporting date will be crowned Miss Jabberwock. The winner will be
announced on the night of the Jabberwock Gala event. In the spirit of fair competition, the
amount of the funds raised by each participant will be a confidential matter between the
participant, her parent(s) or guardian(s) and the bonded financial officers of the Durham
Alumnae Chapter of Delta Sigma Theta Sorority, Inc.
4
Participant Attire
Jabberwock is a special event. At the end of the fundraising period, the event will
culminate in an evening of elegance, recognitions and scholarship awards. The participant, her
parent(s) or guardian(s) and her marshals all participate in the Gala event. This is a formal
occasion and requires formal attire (gown and tuxedo) for all participants.
Formal attire is required and specific to each participant. The formal debutante attire is:
White formal gown, short sleeved (not sleeveless),
pure white (not ivory, off-white or ecru)
Full cut (not fitted to the body), scooped neckline (not off the shoulders, not on the
neck), no splits or sheerness in the dress
Full skirt (no straight or fitted skirts)
Long, white opera length gloves
White or neutral pumps (no open heel and no open-toe)
Jewelry will be provided by the Jabberwock Committee
Parents or Guardians Attire
Formal attire is required for participating parents and guardians. Formal gowns are floor
length. Tea-length gowns or dresses are an acceptable substitute.
Marshals
In Jabberwock, there are two categories for Marshals: Senior Marshal and Junior
Marshal. It is the responsibility of Jabberwock participants and/or her parent(s)/guardian(s) to
confirm her junior and senior marshals. Participants are encouraged to consider asking a
brother, other relative or close family friend to fill this important role.
Formal wear selected by the Jabberwock Committee is required for both junior and senior
marshals. The committee will also provide formal wear rental information to assist the marshals
with confirming their rentals.
Senior Marshal
The Senior Marshal is an adult male who performs general accompanying duties for the
Jabberwock participant during the Jabberwock program. This is generally a father, grandfather,
guardian, uncle or adult male family member.
Junior Marshal
The Junior Marshal is a young adult or teen male who performs general accompanying duties
for the Jabberwock participant during the Jabberwock program. This is generally a dependable
schoolmate, friend, brother or other relative. In addition, Junior Marshals will be invited to
participate in select Jabberwock activities during the program. If the selected Junior Marshal
is under the age of 18, he must have approval from a parent or guardian to participate.
5
Contributions & Patrons
Contributions can be solicited for any amount; however, individuals and businesses that
contribute $25 or more will be listed in the souvenir journal. Contributions for less than $25
will not be listed. Names of patrons and contributions must be submitted by the souvenir journal
submission deadline in order to avoid omissions. Please also note that your listings will be
printed as received and cannot exceed 30 characters (including titles or honorifics i.e. Atty.,
PhD, MD, etc.). Please make sure listings are accurate and legible.
Maximum (30 characters)
*Listings that exceed 30 charters will be excluded.
Examples
Cheryl A. Canino, Esq. (22 characters) Nina Allen & Thomas Perry (25 characters)
Mr. & Mrs. Gerald Times (23 characters) Mr. & Mrs. Kenneth and Mamie Bailey * (35 char.)
Ampix Photography Studio (24 characters) John Weaver-Bey (15 characters)
Patrons will be listed in the following categories:
**Prices are under review and subject to change**
Silver $25 - $49
Gold $50 - $74
Diamond $75 - $99
Platinum $100 – Above
6
Advertisements
Participants are encouraged to solicit commercial ads from businesses and personal ads
from family and friends. When soliciting, please complete the Advertising Contract, give a copy
to the purchaser as a receipt, and turn in a copy with your ads. Additional forms are available
from the Jabberwock Chair or responsible committee member. Advertisements must be
submitted electronically in camera-ready format.
Cost of Ads
**Prices are under review and subject to change**
Full Page $175
One-Half Page $100
Money for all ads must be received by the souvenir journal submission deadline in
order for them to appear in our souvenir journal. Ads must be paid in advance before they can
be included in the souvenir journal and/or credited to the participant’s overall total. All
persons and/or organizations purchasing a full-page ad, a half-page ad or making a donation as
a Platinum Patron will receive a copy of the Jabberwock souvenir journal if requested.
Other Fundraising Events
In addition to soliciting ads or other contributions, you may have fundraising events;
however, you may not do it as a fundraising event in the name of Durham Alumnae Chapter
or Delta Sigma Theta Sorority, Inc. You may do this solely as a Jabberwock participant.
Money that you collect from this type of activity will be credited to your total. As a participant
of Jabberwock, you will agree and attest by signature that ANY AND ALL funds raised as a
Jabberwock participant must be submitted to the Sorority. This is a legal requirement.
PERCENTAGE RECEIVED FROM MONEY RAISED
$10,000 or more 75%
$7,000 to $9,999 60%
$4,000 to $6,999 55%
$3,999 or less 50%
The participant who raises the most money will be crowned Miss Jabberwock. Participants will
receive their scholarship award on or before July 15th following their graduation from high
school.
7Durham Alumnae Chapter
Delta Sigma Theta Sorority, Inc.
JABBERWOCK
ADVERTISEMENT CONTRACT
(To be completed by Advertisement Sponsor)
I will support the Jabberwock Scholarship Program, sponsored by the Durham Alumnae
Chapter of Delta Sigma Theta Sorority, Inc. by placing the following ad or patron listing in the
souvenir journal. Donations are not tax deductible. I understand that my listing(s) will be
printed as received and cannot exceed 30 characters (including titles or honorifics i.e. Atty.,
PhD, MD, etc.). It is my responsibility to ensure my submissions are accurate and legible.
Maximum Patron Listing Length (30 characters)
Business listings do not require titles.
Please mark the appropriate boxes
Check One Ad Description Price
Full Page $175
Half Page $100
Silver Patron $25 - $49
Gold Patron $50 - $74
r
Diamond Patron $75 - $99
Platinum $100 - above
**Prices are under review and subject to change**
PLEASE PRINT
Name of Business (if applicable): Street Address:
Subscriber/Contact Name: City, State and Zip Code:
Title: Telephone:
Authorized Signature:
Checks and Money Orders are strongly preferred. Please make all checks and money orders
payable to: DAC-DST and add Jabberwock Scholarships and participant name in the
memo line.
Amount Paid: Date: Rcv’d by: Reviewed by:
Participant Selling Advertisement:
8Tips and Guidelines for Success
We want your Jabberwock experience to be as memorable and rewarding as possible.
To make the most of this experience and to ensure successful fundraising, accurate reporting
and recording of funds submitted, we ask that you please adhere to the following tips and
guidelines:
1. Enjoy your quest for Miss Jabberwock!
2. Consider keeping a scrapbook of your Jabberwock experience.
3. Select your Senior Marshal and Junior Marshal early (consider using relatives).
4. Encourage your marshals to reserve their formal attire early.
5. Secure your formal white gown early.
6. Add Jabberwock activities to your calendars. These events have been planned just for you
to bond with the participants and committee members.
7. Inform employer of planned activity dates, so you will be able to fully participate.
8. Maintain your lady-like appearance in actions and dress.
9. Continue to be a student in good academic standing in your school.
10. Keep your parents or guardians informed of our Jabberwock activities.
11. Utilize your Jabberwock contacts – we are here to help you!
During Fundraising Process
1. Make contacts for contributions early and follow-up (email, phone calls, in-person visits).
2. Encourage contributors to support your fundraisers and/or group fundraisers.
3. Consider making contact with out-of-town contributors first.
4. Keep names and addresses of contributors.
5. Write thank you notes to contributors.
9Collection of Funds
Please make appointments for fund submission with 48 hours’ notice.
Preparation for collection:
* Know your total prior to our meeting.
* The collection is much more efficient when money has been totaled and checks are grouped
prior to the meeting.
* Make sure “Jabberwock Scholarship-Participant Name” is written on the memo line of all
checks.
* Please provide checks (separate from all other documents) in a stack grouping like amounts
together (e.g. all $25 checks together, all $50 checks together, etc.). Cash can be deposited,
but it is discouraged. Please do not bring coin change.
* Remove all paperclips, rubber bands, etc. prior to meeting with the Asst. Financial Secretary.
* Schedule meetings with Asst. Financial Secretary per the suggested calendar dates. Arrive 10
minutes prior to appointment time.
*Log all transactions, dates and amounts. You will be required to confirm the amounts and
reconcile the totals.
* Remember that fund submissions are confidential. Please refrain from discussing submission
amounts with other participants or anyone other than the bonded financial officers of Durham
Alumnae Chapter, Delta Sigma Theta Sorority, Inc.
For your convenience, you will receive a list of all Jabberwock contacts. Please direct all
funds collection questions to the Asst. Financial Secretary and all other Jabberwock
questions should be directed to the Jabberwock Committee Chair or other appropriate sub-
committee member.
Preparation for Patron List:
* Participants/Parents are asked to provide a typed patron list for each patron category.
These must be submitted electronically to the committee preparing the souvenir journal.
* Check and recheck all names for accuracy before submitting.
*All monies for patrons and ads listed in the souvenir journal must be received by the
announced deadline date! These must be delivered electronically (delivery mechanism
will be provided by the Souvenir Journal Committee).
**Parents/Participants will have the opportunity to review their Patron list. Please
contact the Assistant Financial Secretary to schedule your appointment.
10Suggestions for Jabberwock Fundraising
Fundraising is more than raising money. It’s a personal achievement toward accomplishing
goals to benefit others as well as yourself. Here are some suggestions to assist you in reaching
your goals and maximizing your educational potential.
Donations – Patrons Yard Sales
Raffles Candy Sales
Car Washes Mother/Daughter Tea
Silent Auctions Old school Dances
Jewelry parties Adult Hosted Wine tasting
Skate Parties Holiday wreaths & bows
Bake Sales, Dinner Sales Solicitation Letters & Brochures
Patrons
1. Ask for contributions from businesses your family patronizes:
Beauty Salons Law Firms
Insurance Companies Churches
Barber Shops Florists
Doctors Clothing/Shoe Stores
Restaurants Cleaners
2. Make contact in person if possible
Donations
1. Carefully design a solicitation letter
*MUST be approved by the Jabberwock Committee Chair and the Chapter President
prior to distribution*
2. Be specific regarding purpose, dates, deadlines, and categories of giving
Yard Sales
1. Collect items from family, friends and neighbors
2. Label according to sizes, prices
3. Arrange in orderly manner
4. Advertise early
5. Choose a well populated area
116. Ask for Yard Sale Packet from Durham Herald-Sun
7. Make signs
8. Take at least $20 in change/small bills
Bake Sales
1. Arrange attractively
2. Consider special diets, (i.e. bran muffins)
3. Advertise early
4. Have a variety of items
5. Choose items that won’t spoil easily
6. Price items well
7. Take at least $20 in change/small bills and coins if needed
Raffles - Examples
1. Gas Card
2. Electronics
3. Quilts
4. Autographed memorabilia, i.e. sneakers, basketballs
5. Shows/Concert Tickets
6. Art
Solicitation Letters / Brochures
1. Teachers
2. Relatives
3. Businesses
4. Churches
5. Sorority and Fraternity Members
6. Out-of-Town Family Contacts
Car Washes
1. Make signs large enough to be seen from the street
2. Advertise
3. Location – Location – Location (get permission first i.e. business parking lot)
4. Have enough supplies to last several hours i.e. buckets, rags/towels, mild detergent, tire cleaner
Candy Sales
1. Order early
2. Have a parent or guardian review the contract
3. Ask dependable friends to help
Auctions
1. Select new items
2. Silent Auction (include paper for writing prices)
3. Select an appealing location, i.e. recreation centers
4. Develop invitations/invitation list
5. May combine with receptions, dances, and dinners. Choose an auctioneer that has
personality and humor–a good speaker.
12Dances/Skating Parties
1. Have a parent or guardian negotiate and confirm facility contract
2. Organize
3. Great events to announce raffle winners
4. Set a reasonable price
5. Have an adult chaperone
Hair Cut-A-Thon
1. Select a stylist (should be a close friend) to donate time and money or to give percentage
of money for cuts
2. Advertise
3. Ask for bargain prices
General Tips
1. Keep accurate record of monies raised
2. Pay any bills for expenses promptly
3. Try to submit monies at least a week after an event
4. Start events on time and end on time
5. Be prepared to give receipts upon request
6. Send thank you notes promptly
7. Do not keep large sums of cash on your person or in your home, schedule an appointment
with the Asst. Financial as soon as you confirm the event date and chose a date
immediately following the event
8. Always reiterate monies are raised for scholarships
9. Be fair and honest
13Proposed Jabberwock Timeline
Month Activity Details/Why
May – June Interest Meetings Share information about our program, answer
questions and encourage rising juniors and seniors to
participate.
June Complete application Submit application materials ahead of
the June 30th deadline date.
June - August Assemble your support Gather your ‘steering committee’ that will help
group organize and facilitate your fundraisers. You should
meet /communicate with them periodically
throughout the fundraising period.
June - August Start putting together Organize your contacts so that you will be
your potential donor ready when solicitation begins
lists w/contact info.
June - August Choose Marshals Your marshal choices should be completed and
submitted by Sept 1st. The junior marshal will need to
have a permission form and waiver & release. The
senior marshal will need to complete the waiver
& release.
June - August Find white shoes It is harder to find white shoes closer to the gala. Go
(closed toe and ahead and look now while inventory is more
heel) readily available.
June - September Begin preparing You can start to draft your documents so that you are
solicitation more prepared ahead of the Marketing and
letter/brochure Fundraising 101 activity session.
June 30 Application Deadline Complete and submit application packets with $100
application fee to the Jabberwock Committee
(cashier check, money order, or PayPal)
July Debutante Notification Selected debutantes and her parents/guardians will be
notified by email and will need to confirm their
attendance at other important upcoming dates.
TBA Debutante Social First fun bonding event, additional details TBA.
TBA Past President’s Tea Hosted by the past presidents of the Durham Alumnae
Chapter of DST, Inc. First formal meeting with
debutantes and their mothers/guardians.
14August Begin looking for Start early. This may take more time than you think.
dresses In addition to bridal boutiques, also check
consignment shops, as well as with family and
friends who have previously participated in similar
activities.
September Debutantes meet DAC We’re all in this together, so it’s important that the
chapter members and debutantes and chapter members meet. Because
begin marketing and formal fundraising begins in October, preparations
fundraising process have to begin in September.
October Fundraising Kick-Off Once your documents are approved, you can begin
to solicit funds. Start distributing your marketing
pieces to family, friends, and community businesses.
October - Submit Funds Refer to the collection schedule for details. Do not
January hold donor’s checks. Make regular appts. With asst.
financial secretary to submit funds as you receive
them.
October Rehearsals Initial meeting with Dance Committee and set
rehearsal dates for participants. Rehearsals are
required and a schedule will be provided to ensure
participation.
October Finalize dress & shoe Please provide a photo of your dress for approval
selection before you buy it. Once approved, do complete
your purchase as soon as possible.
October - Prepare Patron Lists & You should be keeping up with your supporters
January Ads and their giving levels as you go. Compile this
information for submission for the souvenir
journal.
November Initial Follow Up When you send out solicitation letters and brochures,
you should follow up with your supporters and
donors to remind them to actually send you their
nd
donation. Gently give them a specific date.
November Start your 2nd Your secondst
major fundraiser should kick off by
Fundraiser November 1 at the latest.
November Rehearsals Rehearsals begin and are required, so all
participants are expected to be present.
November Jr. & Sr. Marshal attire Junior & Senior Marshals will need to be fitted and
pay tuxedo deposit by date TBD so they can be
photographed for the souvenir journal.
November - Periodic Follow ups Make calls/send e-mails to follow up and remind
December donors of deadlines for ads and patrons.
15Month Activity Details/Why
December - Rehearsals Rehearsals are required. Participants, junior and
February senior marshals are expected to make every effort to
attend all rehearsals.
January Photos Debutants and junior marshals will be photographed in
formal attire for the souvenir journal. Additional
photos with mentors will also be taken.
January Jr. & Sr. Marshal Junior and senior marshals will follow-up to
follow up fittings determine if new measurements are needed.
December Begin to wrap up You should plan to wrap up your major
fundraising in late fundraising so that you can submit all checks in
December early January. The finance team will provide a
date.
December - Last day for All ads and patron lists will be submitted
January Ads/Patrons in late electronically. The final date for items for the
December/Early souvenir journal will be provided.
January
January Final Collections Finance team will provide final collection dates. This
date will be about 2-3 weeks before the gala.
February Gala The ‘big day’!!!
March Send Thank You Be sure to follow up by sending thank-you notes to
Notes all of your supporters and letting them know the
outcome of your hard work.
March Distribute Souvenir Give souvenir journals to your platinum patrons and
Journals donors who purchased ads.
16APPLICATION PACKET INFORMATION
The Jabberwock application consists of all of the following forms and the submission deadline is TBA.
$100 Non-Refundable Application Fee payable by PayPal, check or money order made payable to
DAC – DST. On the memo line of your check or money order, please add the words Jabberwock
application fee for (debutante's name). Please add the same where indicated if you are paying by
PayPal. Note: this fee does not go towards monies raised in your quest to become Miss Jabberwock.
Complete and sign all forms, waivers and releases contained herein.
E-mail Photo of Participant to jabberwock@durhamdst.org
(Does not have to be a head shot from a professional photographer, but the participant
should look professional in the photo).
Applications may be mailed to:
Delta Sigma Theta Sorority, Inc.
Durham Alumnae Chapter
ATTN: Jabberwock
P.O. Box 2882
Durham, NC 27715-2882
PLEASE NOTE: The application packet is not complete until ALL of the required
forms and fees have been received by the Jabberwock Committee.
Participant Notification
Participants will receive email notification of the receipt of a completed application with
instructions for next steps.
17Delta Sigma Theta Sorority, Incorporated
Risk Management Manual
Revised 09/2020
APPENDIX B3
YOUTH CODE OF CONDUCT
1. Respect all participants (other youth and adult volunteers) by not using foul, hurtful or obscene
language or engaging in physical violence, bullying (including cyber-bullying) 7 or other
aggressive behaviors that threaten the safety of others.
2. Respect the property rights of others. This means do not damage or deface the building or
property within the building where chapter activities are held; do not damage or take the personal
property of any other participant or volunteer; and do not use Delta’s name or any symbol or
logo (Delta’s intellectual property) on any clothing, books, bags, or other items.
3. Return supplies to their proper place after using them.
4. Clean up all work areas properly.
5. Listen carefully to directions and when someone else is talking.
6. Respect designated quiet areas, such as homework/reading area.
7. Stay within the program’s designated areas within the building.
8. Cooperate and participate in organized activities.
9. Assume full responsibility for all personal belongings. Please leave valuables at home.
10. Do not bring any weapons, cigarettes/drugs, alcohol, or anything illegal to any activity at any
time.
Sanctions for Violating Code of Conduct
Bad Language/Abusive Teasing and Related Acts:
1st Time: Verbal warning, parent or guardian notified from this point forward
2nd Time: Loss of privileges
3rd Time: 1-week suspension from program
Next occurrence youth is removed from the program.
Physical Violence and Other Misconduct:
1st Time: Removal from situation, loss of privileges, guardian notified from this point forward
Next occurrence youth is removed from the program.
Illegal Substances or Dangerous Weapons
1st Time: Youth is removed from the program. If a youth is in possession of an illegal substance or
dangerous weapon, the police will be notified as well.
(Continued on next page)
18Delta Sigma Theta Sorority, Incorporated
Risk Management Manual
Revised 09/2020
APPENDIX B3 (Con’t)
(Student Participant)
With my parent or other adult, I have read the Code of Conduct and sanctions for violating
the Code. I understand the Code and the sanctions. I will follow the Code of Conduct.
____________________________________________________________________
Signature Date
____________________________________________________________________
Print Name
**************
(Parent)
I have read and understand the Code of Conduct and sanctions for violating the Code of
Conduct. I understand that my child’s compliance with the Code of Conduct is a condition of
her/his participation in the program. I agree that the sanctions for violating the Code of
Conduct are reasonable and will help my child comply.
______________________________________________________________________
Signature Date
______________________________________________________________________
Print Name
19Durham Alumnae Chapter
Delta Sigma Theta Sorority, Inc.
JABBERWOCK PARTICIPANT PROFILES
PARTICIPANT / DEBUTANTE PROFILE
(PRINT CLEARLY)
PARTICIPANT/DEBUTANTE NAME:
__________________
(First) (Middle) (Last)
ADDRESS: _______________________________________ ________
CITY: _____________STATE: ________ ZIP: ____________
DATE OF BIRTH: / / AGE: T-SHIRT SIZE:____________
CELL PHONE: __________________
E-MAIL ADDRESS: __________
SCHOOL: ____CURRENT GRADE: _ ______
COLLEGE PREFERENCE(S): ____________________________________________________
INTENDED COLLEGE MAJOR: _______________
HOBBIES / SPECIAL INTERESTS: ________________________________________________
________________________________________________________________________________
COMMUNITY ACTIVITIES / INVOLVEMENT: ________________
_________________________________________________________________________________
PARENT/GUARDIAN I - FULL NAME: _________________
PARENT/GUARDIAN I - CELL: _________________
PARENT/GUARDIAN I - EMAIL: _________________
PARENT/GUARDIAN II - FULL NAME: _________________
PARENT/GUARDIAN II - CELL: ___________________________________________________
PARENT/GUARDIAN II - EMAIL: _________________
20Durham Alumnae Chapter
Delta Sigma Theta Sorority, Inc.
JABBERWOCK
JUNIOR MARSHAL PROFILE
We must have a completed hard copy of this form for parental consent.
Jr. Marshal Parents/Guardians must also submit the Waiver & Release Form.
JUNIOR MARSHAL NAME:
__________________
(First) (Middle) (Last)
DEBUTANTE NAME:
__________________
(First) (Middle) (Last)
JR. MARSHAL ADDRESS: ________________________ _____
CITY: _____________STATE: ________ ZIP: ____________
DATE OF BIRTH: / / AGE: T-SHIRT SIZE: ____________
CELL PHONE: __________________
E-MAIL ADDRESS: __________
SCHOOL: ____CURRENT GRADE: _ ______
COLLEGE PREFERENCE(S): ____________________________________________________
INTENDED COLLEGE MAJOR: _______________
HOBBIES / SPECIAL INTERESTS: ________________________________________________
I, ________________________________________ agree to uphold all of the responsibilities
designated to the position of Junior Marshal.
Signature of Junior Marshal Date
Signature of Parent or Guardian Date
21Durham Alumnae Chapter
Delta Sigma Theta Sorority, Inc.
JABBERWOCK
SENIOR MARSHAL PROFILE
Senior Marshals will need to complete and submit the Waiver & Release Form
to the Durham Alumnae Jabberwock Committee
SENIOR MARSHAL NAME:
__________________
(First) (Middle) (Last)
DEBUTANTE NAME:
__________________
(First) (Middle) (Last)
SR. MARSHAL ADDRESS: ________________________ _____
CITY: _____________STATE: ________ ZIP: ____________
CELL PHONE: __________________
E-MAIL ADDRESS: __________
I agree to uphold the responsibilities designated to the position of Senior Marshal.
Signature of Senior Marshal Date
22Jabberwock Participant/Parent/Guardian
Consent Form
Durham Alumnae Chapter
Delta Sigma Theta Sorority, Inc.
P. O. Box 2882
Durham, NC 27715
I, agree to the requirements
below and give permission for my daughter,_____________________________________
to participate in the 2021-2022 Jabberwock program sponsored by the Durham Alumnae
Chapter of Delta Sigma Theta Sorority, Inc.
Jabberwock is a five to eight-month program for young women who are rising juniors or seniors
in the high school year of which they are participating. This is a constructive program designed
to enhance leadership, life and social skills. It is also a fundraising initiative that will award
scholarship funds the title of Miss Jabberwock to the highest fundraiser.
As a participant and parent of a participant in Jabberwock, I/we are responsible for the
following commitments to the program sponsored by the Durham Alumnae Chapter of
Delta Sigma Theta Sorority, Incorporated.
Active participation and attendance in all activities, including fundraising events and rehearsals
Development and execution of respectful solicitation strategies
Timely and accurate recording of names and advertisements for souvenir journal
Sending “Thank You Notes” to all contributors
Timely reporting of all funds received or solicited as a part of the Jabberwock program
Adherence to submission dates and times for all patron’s list
_______ Participant Initial
________ Parent/Guardian Initial
23Consent Form Con’t
By signing this Consent Form, we/I agree to submit the following requirements for participation
in the Jabberwock Program sponsored by the Durham Alumnae Chapter of Delta Sigma Theta
Sorority, Incorporated. We also understand that our participation is pending until we receive
written notification that our completed packet has been receive and is approved.
$100 Application Fee (non-refundable, PayPal, check or money order made payable to,
DAC – DST. Please put Jabberwock application fee for (name of participant) on checks or money
orders and add the participants name to the note section Please note that this fee does not go towards
monies raised in your quest to become Miss Jabberwock.
Complete and sign all forms, waivers and releases contained herein.
E-mail Photo of Participant to jabberwock@durhamdst.org
(Does not have to be a headshot from a professional photographer, but the participant
should look professional in the photo).
We/I understand that if for any reason I, decide to
discontinue this program before its completion, I forfeit my $100 Application Fee and any
scholarship funds raised at that point.
We/I also understand that any/all disrespectful and inappropriate behavior or language will not
be tolerated and will be grounds for sanctions as outlined in the program’s Youth Code of
Conduct policy.
I understand and agree to the scholarship percentages that have been outlined. I understand
participants will receive their scholarship award on or before July 15th following their
graduation from high school.
Signature of Parent/Guardian Date
Signature of Participant Date
24Delta Sigma Theta Sorority, Incorporated
Risk Management Manual
Revised 09/2020
APPENDIX B1
PARENTAL/GUARDIAN AFFIRMATION
I,______________________________________________ , hereby give my permission to the Durham Alumnae
Chapter of Delta Sigma Theta Sorority, Incorporated for _______________________________to participate
in the Jabberwock youth initiative (including planned activities), and I hereby attest, under penalty of
perjury, that I have the legal authority to authorize such participation.
Printed Name: _______________________________________
Signature: __________________________________________Relationship to child: ___________________
Date:__________________________________
WAIVER AND RELEASE
I, , Parent/Guardian, on behalf of
(“Participant Minor Child”) do hereby release, waive,
discharge and covenant not to sue and agree to hold harmless Delta Sigma Theta Sorority,
Incorporated (“Delta”), its officers, National Executive Board, employees, members, local
chapters, representatives, agents, affiliates, and assigns (collectively “Releasees”), from any and
all claims, demands, and actions of any and every kind directly or indirectly arising out of or
relating in any respect to Participant Minor Child’s participation in the Jabberwock Program.
My waiver and release of all claims, demands, actions, and liability shall include without
limitation, any injury, illness, death, property damage or loss to the Participant Minor Child
which may be caused by any act, or failure to act, by the Releasees, unless such injury, illness,
death, property damage or loss is a direct result of the willful misconduct of any Releasee.
I understand that, without limitation of the foregoing, neither Delta, nor the Program, shall be
liable and each is hereby released from all claims that may arise from loss or damage to the
Participant Minor Child’s personal property.
Parent/Guardian Signature: ____________________________________________
Date:
25Durham Alumnae Chapter
Delta Sigma Theta Sorority, Inc.
2023 JABBERWOCK
ADDITIONAL REQUIRED
FORMS
YOUTH PICK-UP AUTHORIZATION FORM
FIELD TRIP PERMISSION FORM
PHOTOGRAPH, MEDIA AND VIDEO AUTHORIZATION RELEASE FORM
EMERGENCY MEDICAL TREATMENT AUTHORIZATION PACKET
MEDICAL INFORMATION FORM
NON-PRESCRIPTION MEDICATION PERMIT
PHYSICIAN & INSURANCE INFORMATION
EMERGENCY CONTACT INFORMATION
MEDICAL AUTHORIZATION FORM
PARENTAL PERMISSION FORM - ADMINISTRATION OF PRESCRIPTION
MEDICATION ADMINISTRATION PROCEDURES
26Delta Sigma Theta Sorority, Incorporated
Risk Management Manual
Revised 09/2020
APPENDIX B4
YOUTH PICK-UP AUTHORIZATION FORM
I authorize the persons listed below to pick-up my child from the Jabberwock program. For my
child’s safety, I understand that all authorized persons on the list below will be asked to show
photo identification before my child is released to them; therefore, I will notify all authorized
persons of this requirement so that they will have photo identification with them when they
arrive to pick-up my child. (Please include names of either parents or guardians on list below).
Name Relationship
Home Phone Work Phone Cell Phone
Name Relationship
Home Phone Work Phone Cell Phone
Name Relationship
Home Phone Work Phone Cell Phone
Name Relationship
Home Phone Work Phone Cell Phone
Name Relationship
Home Phone Work Phone Cell Phone
By signing below, I verify that I have read and agree to the Student Pick-Up policies described
above and authorize the Durham Alumnae Chapter to release my child to the persons listed
above. I also agree to notify the Durham Alumnae Chapter in writing of any changes to the
above list of authorized persons.
Parent / Guardian Signature _______Date __________Durham Alumnae Chapter
Delta Sigma Theta Sorority, Inc.
Field Trip Permission Form
I/We, (“Parent/Guardian”), as parent(s) or legal
guardian(s) of (“Child”), give permission for
my/our Child to participate in the Jabberwock Program’s (the “Initiatives”) activities taking
place off site. I/we understand that transportation to and from these activities will be provided for
my/our Child by the Chapter.
I/We understand that the field trips are part of the Initiatives and if I/we choose to not have
my/our Child participate in one or more off-site activities, I/we must make other care
arrangements for my/our child during the times of that field trip activity.
I/We assume all risks and hazards of loss or injury of any kind that may arise in connection with
such trips, except for gross negligence or intentional infliction of harm by the Initiatives, its
officers, agents or employees.
I/We do hereby agree to release and hold harmless the Initiatives, Delta Sigma Theta Sorority,
Incorporated, its officers, National Executive Board, employees, members, representatives,
agents and assigns from any and all claims, costs, suits, actions, judgments, and expenses for any
damage, loss, or injury to my/our child or damage to my/our child’s property arising from
my/our child’s participation in field trips, other than damage, loss, or injury that results from
gross negligence or intentional infliction of harm by the Initiatives, Delta Sigma Theta Sorority,
Incorporated, its officers, National Executive Board, employees, members, representatives,
agents and assigns.
Parent/Guardian Signature Date
Parent/Guardian Signature DateDelta Sigma Theta Sorority, Incorporated
Risk Management Manual
Revised 09/2020
APPENDIX B2
PHOTOGRAPH, MEDIA AND VIDEO AUTHORIZATION RELEASE FORM
I/We, ______________________________________ (“Parent/Guardian”), as parent(s) or legal
guardian(s) of _________________________________________, give permission for the
____________________________ Chapter of Delta Sigma Theta Sorority, Incorporated (the “Chapter”)
to publish on the Internet or media still photographs or moving images, including, if applicable any sound
recordings accompanying the images (“Images”) taken of my child during participation in
______________________________________Youth Initiative Program activities, without payment or
any consideration and without notifying me in advance.
I/We also give permission for the Chapter to highlight my child’s achievements and activities in efforts to
promote the youth initiative program through newspapers, radio, TV, the web, DVDs, displays, brochures,
and other types of media without payment or any consideration and without notifying me.
I/We understand and agree that these Images will become the property of the Chapter, which shall have
complete ownership of the Images. I hereby irrevocably authorized the Chapter to publish or distribute
these Images for the purpose of publicizing the Chapter’s programs, including the __________________
Youth Initiative Program or for any other lawful purpose. In addition, I waive any right to inspect or
approve the finished product wherein my child’s likeness appears. Additionally, I waive any rights to
royalties or other compensation arising out of or related to the use of the Images.
I/We hereby hold harmless and release and forever discharge the Chapter and any of its officers and
members; Delta Sigma Theta Sorority, Incorporated; its officers; National Executive Board; employees;
members; representatives; agents; and assigns from any and all claims, costs, suits, actions, judgments,
and expenses which my child, his/her heirs, representatives, executors, administrators, or any other
persons acting on his/her behalf have or may have by reason of the use of the Images. This release
specifically includes, without limitation, a complete release and discharge of any liability by virtue of any
editing, distortion, alteration, or optical illusion, whether intentional or otherwise, that may occur or be
produced in the taking of or editing of said Images, unless it can be shown that such was maliciously
caused, produced and published solely for the purpose of subjecting my child to conspicuous ridicule,
scandal, reproach, scorn and indignity.
I/we hereby certify that I/we are the parents/guardians of ________________________________,
authorized legally to give this consent, and do hereby give my/our consent without reservation to the
foregoing on behalf of my/our child.
Parent/Guardian Signature ________________________________________Date_________________
Print Name ____________________________________________________
Parent/Guardian Signature ________________________________________Date_________________
Print Name ____________________________________________________Delta Sigma Theta Sorority, Incorporated
Risk Management Manual
Revised 09/2020
APPENDIX B7
EMERGENCY MEDICAL TREATMENT AUTHORIZATION PACKET
Name of Minor:
Date of Birth Age
Address:
City/State/Zip Code
Parent/Guardian Home Phone
Cell Phone E-mail Address
Minor’s Gender Height Weight
HEALTH INFORMATION
Below please check any current health condition that may require attention during the Program
day. Also complete and submit the Medication Authorization Form if your child has health
conditions that require medication during the Program day.
__ Allergies/Sensitivities (be specific)
Foods
Medicines
Bee sting or insect bite
Other
__ Asthma __ Inhaler required at Program
__ Vision Problems __ Glasses __ Contacts
__ Hearing Problems __ Hearing Aid(s)
__ ADD/ADHD __Yes __No
__ Other
List all medications and dosages your child receives on a continual basis:Delta Sigma Theta Sorority, Incorporated
Risk Management Manual
Revised 09/2020
MEDICAL INFORMATION FORM
Today's Date:
Health History:
Child’s Name (Last, First, M.I.):
Gender (check one): Male Female DOB (mm/dd/yy):
Parent/Guardian Name:
Does Parent/Guardian live in home with child?
Parent/Guardian Name:
Does Parent/Guardian live at home with child?
Is/Has child been under regular supervision of a physician?
Name and address of physician
Date of last physical exam:
Health and Developmental History:
Childhood illness: Check any that apply
__ Asthma __ Chickenpox __Diabetes __ Epilepsy __ Hay Fever __ Measles __ Mumps
__ Poliomyelitis __ Rheumatic Fever __Ten-Day Measles (Rubella) __ Three-Day __
Other (please list):
Does child have any significant health history, conditions, communicable illness, or restrictions
that may affect child’s participation in the Durham Alumnae Chapter’s Jabberwock Youth
Program?
(check one) __ None __ Yes
If yes, please provide detailed explanation
Does child have any significant food/medication/environmental allergies that may require
emergency medical care at the Durham Alumnae Chapter’s Jabberwock Youth Program?
(check one) __ None _Yes
(Continued on next page)Delta Sigma Theta Sorority, Incorporated
Risk Management Manual
Revised 09/2020
If yes, please provide detailed explanation
Specify any other serious or severe illnesses or accidents:
Does child take prescribed medications?
Name the medications:
Frequency Taken:
(For any medications or treatment required during the course of the Durham Alumnae Chapter’s
Jabberwock Youth Program, a Medication Authorization Form should be completed and
submitted with this form.)
Does child take any over the counter medications frequently?
Name the medications:
Frequency Taken:
Does child have any allergies?
Specify:
Does the student use any special device(s) (i.e. hearing aids, cochlear implants, etc.):
Name the Device(s):
Reason for use:Delta Sigma Theta Sorority, Incorporated
Risk Management Manual
Revised 09/2020
NON-PRESCRIPTION MEDICATION PERMIT
PLEASE CHECK those medications you give permission for your child to receive (generic
equivalent may be used). I/We understand that medications will be administered with discretion
by an authorized Program employee and in accordance with established protocols developed by
the Program.
The following nonprescription medications may be available to your child:
__ For headaches/fever/muscle aches/pain/cramps: Acetaminophen (e.g., Tylenol,
including Junior Strength), Ibuprofen (e.g., Advil, including Children’s liquid,
Motrin), Naproxen (Aleve), Midol, & Excedrin.
__For bites/allergic rashes: Anti-itching lotion (e.g., Calamine or Hydrocortisone cream 1%),
Benadryl liquid or capsules.
__For nasal congestion/sinus pressure: Decongestant
__For sore throat: Throat lozenges (e.g., Cepacol lozenges)
__For coughs: Cough drops/lozenges or cough suppressant.
__For upset stomach: Antacid liquid or chewable tablets (e.g., Mylanta)
__For sun protection: Sunscreen lotion SPF 30.
__ I DO NOT WANT ANY MEDICATIONS GIVEN TO MY CHILD.
Parent/Guardian Signature Date
PHYSICIAN & INSURANCE INFORMATION
Name of Child’s Physician Phone
Health Insurance Company Phone
Policy Number Group Number
Insurance Company Address
City/State/Zip Code
Name of Policy Holder
Name of Policy Holder’s EmployerDelta Sigma Theta Sorority, Incorporated
Risk Management Manual
Revised 09/2020
EMERGENCY CONTACT INFORMATION
Parent/Guardian #1
Name Relationship
Street Address
City State Zip Code
Home Phone Work Phone Cell Phone
E-mail address
Parent/Guardian #2
Name Relationship
Street Address
City State Zip Code
Home Phone Work Phone Cell Phone
E-mail address
If for any reason I/we cannot be reached, please contact the following person(s) whom I/we
hereby authorize to seek emergency medical or surgical care for my/our child.
Name: Relationship to Student
Home Phone Work Phone Cell Phone
Name: Relationship to Student
Home Phone Work Phone Cell Phone
In the event that the Program is unable to reach any of the individuals named above
promptly by phone, I/we authorize the Program to seek and secure any emergency medical
or surgical care for my/our child. I/We will be responsible for any and all expenses
incurred and authorize the medical facility at which treatment is rendered to release all
necessary information to my/our insurance company.
Parent/Guardian Signature Date
Parent/Guardian Signature DateDelta Sigma Theta Sorority, Incorporated
Risk Management Manual
Revised 09/2020
APPENDIX B8
MEDICATION AUTHORIZATION FORM
(To be filled out by the physician dispensing the medication)
Name of Minor Birthdate
Medication
Dosage
Time of administration
Reason for medication
Route of administration
Possible side effects and significant information
Physician’s signature
Physician’s telephone number
PARENTAL PERMISSION FORM
ADMINISTRATION OF PRESCRIPTION MEDICATION
I/We hereby give permission for
to take at the Jabberwock program as ordered by
his/her physician identified above. I/We understand that it is my/our child’s responsibility to
report to at the appropriate time for the administration of the
medication. I/We further understand that it is my/our responsibility to furnish this medication
and any authorized refills. I/We further understand that Delta Sigma Theta Sorority, Incorporated
(“Delta”), its officers, National Executive Board, employees, members, local chapters,
representatives, agents, affiliates, assigns, the Jabberwock program, its agents, and/or any
employee who administers any drug to my/our child, in accordance with written instructions
from the prescriber, shall not be liable for damages as a result of an adverse drug reaction or any
other injury suffered by my/our child due to the administration or failure to provide the drug. The
Jabberwock program reserves the right to refrain from administering medication if in the
judgment of the Jabberwock program, or other authorized Program officer, agent, or employee
the circumstances do not warrant medication administration.
I/We understand that the medication must be brought to the Jabberwock program by me/us in the
original appropriately labeled container. If I/we cannot bring the medication to the Jabberwock
program, I/we will call the Jabberwock program to inform them that my/our child will be
bringing it, indicating the amount of medication in the container.
Parent/Guardian’s Signature DateYou can also read
