Mentee Consent Form "*" indicates required fields Step 1 of 2 50% Your child has been selected to participate in the Anchored Mentoring Program (Speaking to the Potential, Ability, and Resiliency inside every Child) provided by SCARF Organization Inc. This program consists of group virtual classes focused on Decision Making, Leadership, Character Building, Stress and Insecurity, The Power of Thought, etc. The program also offers your child the opportunity to meet with a mentor individually to participate in volunteer projects and individual discussions. In order for your child to participate in this program. Please complete the following consent form. 1. Participant Information:Participant Name* First Last Date of Birth:* MM slash DD slash YYYY Gender:*Please Check All That Apply:* I permit my child to participate in the Anchored Mentoring Program. * I permit my child to have contact with the SCARF Mentoring Program facilitators outside of my child’s school if and when there is a pre-approved scheduled meeting. Group Travel Consent* I hereby give permission for my child to participate in group travel activities as part of the Anchored Mentoring Program, organized by SCARF Organization Inc. I understand that these activities may include public transportation (i.e. Florida SunRail) to and from designated locations, as well as participation in events, field trips, or other group outings supervised by program staff and mentors. * I acknowledge that all reasonable precautions will be taken to ensure the safety and well-being of my child during these travel activities. I understand that SCARF Organization Inc. and its representatives are not liable for any unforeseen incidents or accidents, provided that standard safety measures have been followed. Photo and Video Release:* I permit SCARF Organization Inc. to use photographs, videos, and/or audio recordings taken during their programs and events that include my child’s image and/or likeness. I agree that any use of my child’s image and/or likeness by SCARF Organization Inc., is without any payment and/or compensation of any kind. I acknowledge that no promises have been made to me in exchange for this Release which represents the entire agreement between me and SCARF Organization Inc., regarding the use of their image and/or likeness. * I understand that the photographs and/or recordings may be used and reused in both printed and electronic materials (including marketing and website materials) developed by SCARF Organization Inc. I release SCARF Organization Inc and its employees, agents, directors, and officers from all claims of any kind arising out of the use of any photographs and/or recordings that contain my child’s image and/or likeness. Parent / Guardian Contact Information* First Name Last Name Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Your PhoneAcknowledgment:*I am signing this release form voluntarily. I am aware that this consent will remain in effect until a written revocation is received by SCARF Organization Inc. I acknowledge that I have read and understood this consent form.Signature*NameThis field is for validation purposes and should be left unchanged.
