PARENT/STUDENT CONTRACT (Must be signed by Parent/Guardian)

By signing above, the parent/guardian and student agree to participate in Movement of Youth (MOY). 

I, Parent/guardian, authorize MOY to obtain and release information about my child to and from his/her school and school staff (including all district and county school schools, non-district charter and independent schools). I authorize the MOY staff to gather my child's grades, schedules, and test scores (report cards and/or End-of-Grade scores) from district and county schools, non-district charter and independent schools. Furthermore, I permit MOY to speak with the teachers and counselors about my child's progress. I understand this information will be kept confidential and that it is necessary for my child to receive maximum support in the program. I also understand that while all information will be kept confidential, some information will be turned over to an outside evaluator who will use the data to conduct an evaluation of the program.

In addition to the release of information mentioned above, the parent/guardian and student also agree:

  • To work hard to have a good relationship with the mentors;
  • Student will attend all required program activities. In the event that student cannot attend an event, parent/guardian or student will notify the program staff within 48 hours of the absence;
  • Student will commit to at least one phone/email exchange with a mentor from the mentoring team per week
  • Student will abide by the rules and regulations of the program;
  • Parent/guardian or student will communicate with the Mentoring Services Director regarding issues of concern at any time during the program; and
  • Parent/guardian and student will fill out a survey at the end of the year.

Parent/guardian and student understand that if student misses three program activities without notifying the program staff within 48 hours, student may lose the privilege of participating in Movement of Youth.