Parent Consent Form

I, , the parent for , do hereby grant permission for AFC's Tutor/Mentor to continue making contact with the above named child and continue to provide tutoring/mentoring support.

I agree to have the above named child follow all Tutoring/Mentoring and understand that any violation on the above named child’s part may result in suspension and/or termination of the Tutoring/Mentoring relationship.

I do hereby give my consent for the above named child to participate in all activities and events sponsored by AFC and to be allowed to leave the child’s home with the AFC volunteer tutor/mentor listed below. I also give my permission for said volunteers to meet with the child’s teacher(s) and/or guidance counselor, and for the release of school/educational, medical, and mental health care records.

I hereby acknowledge that the above named child will be transported by his/her volunteer tutor/mentor while participating in the AFC Tutoring/Mentoring Program, and that such transportation is voluntary and at his/her own risk.

I understand that, while every effort is made to ensure the health and safety of each participant, some outdoor activities (hiking, backpacking, camping, etc.) can involve risk and may result in injury. I therefore give my authorization for treatment in case of injury to the following AFC staff members and/or volunteers: