After-School Tutoring Participant Consent Form

Participant Information

Participant Name Grade School Name

Parent/Guardian Information

Parent/Guardian Name Contact Number Email Address

Program Details

I understand that my child will be participating in the After-School Tutoring Program and that the program is designed to provide additional academic assistance outside regular school hours.

I acknowledge that participation is voluntary and that I may withdraw my child from the program at any time by notifying the program staff.

Consent

I consent to my child’s participation in the After-School Tutoring Program. I agree/disagree for my child to be photographed or recorded for program purposes.

Signature

Parent/Guardian Signature Date