Please read this carefully before signing: 

S.T.Y.L.E. Mentoring Program appreciates you and your child’s interest in her becoming a mentee. This application is intended as a means of informing and gaining the consent of the parent/guardian to allow their child to participate in the S.T.Y.L.E. Mentoring Program.  
After receiving this completed application from you, we will evaluate the information and send you a letter letting you know if your child has been accepted into the mentoring program. Much of the information you supply in this application packet will be used to match your child with an appropriate mentor. Therefore, the mentoring staff may, at times, need to access and share this information with prospective mentors and other parties when it is in the best interest of the match. However, we do not reveal names until there is an initial interest from the mentee, parent/guardian, and mentor based first upon anonymous information provided about each other.  
Please initial each of the following:

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* 1. I give my informed consent and permission for my child to participate in the  S.T.Y.L.E. Mentoring Program and its related activities.

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* 2.  I agree to have my child follow all mentoring program guidelines and understand that any violation on my child’s part may result in suspension and/or termination of the mentoring relationship.  

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* 3. I hereby acknowledge that my child will be transported by her mentor and/or S.T.Y.L.E. staff or representatives while participating in the S.T.Y.L.E. Mentoring Program and that such transportation is voluntary and at her own risk.

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* 4. I release the S.T.Y.L.E organization and S.T.Y.L.E Mentoring Program of all liability of injury, death, or other damages to me, my child, family, estate, heirs, or assigns that may result from her participation in the program, including but not limited to transportation, and hold harmless any S.T.Y.L.E. mentor, program staff, or other representatives, both collectively and individually, of any injury, physical or emotional, other than where gross negligence has been determined.

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* 5. (optional) I agree to allow S.T.Y.L.E. to use any photographic image of my child taken while participating in the mentoring program. These images may be used in promotions or other related marketing materials.

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* 6. I understand I must return all of the following completed items along with this  application, and that any incomplete information will result in a delay in my application being processed:  

▪ Contact and Information Release Form 

▪ Interest Survey Form 

By signing below, I attest to the truthfulness of all information listed on this application and agree to all the above terms and conditions.  

Parent/Guardian Signature________________________________________________

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