Parent/Guardian Information I understand that business and community members are participating in this program voluntarily and are not trained youth counselors. Except where prohibited by law, I agree that___________ Elementary, Education Elevators and the Education Alliance will not be liable for any particular results or the actions or inactions of the volunteers, and I will not hold the school district, the Education Elevators or the Education Alliance responsible for any claims or damages known or not yet ascertainable. The program liaisons and my child’s Elevator will have access to my child’s school files which includes monthly grades, absentee, disciplinary and referral records for the purpose of supporting my child’s participation in the program. Education Elevators, the Education Alliance and its representatives will have permission use my child’s photograph or videos of my child as well as quotes by my child for official business of the organization, which shall include but not be limited to: advertising, publications, Web site and news releases. I further understand that mentoring is not intended to replace or substitute the guidance provided by teachers and parents. I have read this form and understand what Education Elevators is. I hereby give my permission for my child __________________ , to participate in this program. ____________________________________________________________________ Parent/Guardian Signature Date Parent/Guardian Questionnaire Name: ______________________ I am the parent/guardian of _______________________ Age: ____ Address:
Parent/Guardian Information I understand that business and community members are participating in this program voluntarily and are not trained youth counselors. Except where prohibited by law, I agree that___________ Elementary, Education Elevators and the Education Alliance will not be liable for any particular results or the actions or inactions of the volunteers, and I will not hold the school district, the Education Elevators or the Education Alliance responsible for any claims or damages known or not yet ascertainable. The program liaisons and my child’s Elevator will have access to my child’s school files which includes monthly grades, absentee, disciplinary and referral records for the purpose of supporting my child’s participation in the program. Education Elevators, the Education Alliance and its representatives will have permission use my child’s photograph or videos of my child as well as quotes by my child for official business of the organization, which shall include but not be limited to: advertising, publications, Web site and news releases. I further understand that mentoring is not intended to replace or substitute the guidance provided by teachers and parents. I have read this form and understand what Education Elevators is. I hereby give my permission for my child __________________ , to participate in this program. ____________________________________________________________________ Parent/Guardian Signature Date Parent/Guardian Questionnaire Name: ______________________ I am the parent/guardian of _______________________ Age: ____ Address:
Parental%20ConsentFormOption2%20082416.docx