The Rising Parent/Guardian Permission Form

Student Name*

First Last

School*

Denny Middle School

Meany Middle School

Parent/Guardian Name

First Last

Parent/Guardian Email*

Parent/Guardian Phone*

Consent*

By selecting the "Yes" checkbox you are signing this agreement electronically.

Yes

Image Release*

I also give permission for a portion of my students recordings and or picture to beshared on social media or for promotional purposes.

Yes

No

Parent/Guardian Signature*

Name

This field is for validation purposes and should be left unchanged.

Seattle CARES Mentoring Movement

Fax: (206) 726-1393

Next Mentor Orientation

RSVP