You're Interested In Joining One of Key 2 Success' Very Amazing Programs in Reading, Math, and/or Art. Check out each program offered and age group before sign up! (2022)!!!  There is something for all ages!
Key 2 Success: Youth Advancement Organization is a nonprofit that supports youth and all their stakeholders!  At the core of our mission is offering positive social engagement opportunities and academic reinforcement to our youth! This is accomplished by providing creative, age appropriate academic and social activities that can lead to successful outcomes. Helping youth increase their desire to learn and the skills to maintain a healthy lifestyle.  Youth who participate in any of our unique programs are encouraged to become more confident, creative, and increase his or her thirst for knowledge.

Mission Statement: To support youth by providing services that promote learning, social, and health advancement in the communities we serve!

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Summer program run from June 24th to July 28th (Summer 2022)
We will continue virtual programming. This year programs will be on Fridays and Saturdays once a week depending on which class you register to attend. Our classes are no longer than 1 hr. each and are very fun as they are led by Youth Workers!!!
Guardian Name: *
Guardian Phone Number: *
Guardian Email (leave blank, if already provided):
Participant Full Name: *
Participant School District: *
Please specify which exact school below: *
Participant Age: *
Race/Ethnic Background: *
Thanks For Expressing Interest In Our Programs! Please Select the one(s) you are interested in below: *
Required
Are you a returning or new participant: *
Please tell us how you heard about this program: *
Please let us know what interested you in our programs and/or what you hope to learn/gain: *
Parental Consent and Waiver Form:
PHOTOGRAPH CONSENT AND WAIVER: I understand that Key 2 Success may photograph my child individually or in group settings. I understand that photos may be used in brochures, web site, newspapers, presentations, and television spots to further publicize the mission of the organization. I give full consent for these and similar uses of my child’s photographic likeness, waiving any liability for Key 2 Success or its directors or employees.

EMERGENCY MEDICAL AUTHORIZATION: I understand that in the event of accident or illness, every effort will be made to contact parent/guardian immediately. If parent/guardian cannot be reached, I authorize Key 2 Success to obtain emergency care for my child.

FIELD TRIP PERMISSION: I/We do hereby agree to release and hold harmless Key 2 Success its officers, Board of Directors, volunteers and employees from any and all claims, costs, suits, actions, judgments, and expenses for any damage, loss, or injury to/of my child or damage to any  property arising from my/our child’s participation in field trips.

CONSENT AND WAIVER to contact the participating child via email/electronic accounts and to communicate and facilitate activities that require media and electronic participation i.e. Google and Zoom releasing and holding  harmless Key 2 Success, its officers, Board of Directors, volunteers and employees from any and all claims, costs, suits, actions, judgments, and expenses for any damage, loss, or injury to/of my child or damage to any  property arising from my/our child’s participation in electronic activities..

CONSENT AND WAIVER to communicate with teachers/school faculty (if conducted) concerning your child’s progress as it pertains to maintaining high performance. Both academically and behaviorally during and between program sessions in our efforts to support participants at all times.

CONSENT AND WAIVER to have access to personal & school data including but not limited to: transcripts/report cards, proof of mail, Test Data (MAP, PARC, PSAT) and homework/learning aids i.e. Compass Learning.

I understand that the director nor many of its volunteers are not teachers and are not ensuring any and all advancement of the students socially, emotionally, or academically and hold harmless Key 2 Success, its volunteers, and directors.

I understand all aspects of this program and release and hold-harmless Key 2 Success from any and all liability associated with this program including but not limited to field trips, carpool, and projects. I fully understand that all precautions have been taken to protect my child including use of any buildings, materials, and transportation. I give permission with full understanding of the risks associated.

 I attest that all paperwork and documents are true and accurate. No false information has been submitted. I acknowledge by typing name at the end of application.


Rules and Regulations:
Below Parent and Participant Should Read Carefully the Following Rules/Regulations: (Signatures Required)

1. Inappropriate behavior is not allowed during session (such as interrupting, leaving the premise, leaving the care of manager, or inappropriate behavior between peers i.e. hugging,  absurdly loud giggling or talking when others are talking or upon entering library, other areas of library or during electronically facilitated).
2. NO child shall enter the company of an adult or group leader without proper greetings and salutations, i.e. saying: Hello, How are you? Saying goodbye, have a nice day! (Is due upon leaving the library or sponsored field trip) and thank you! Cameras
 on for Virtual.  
3. Respect will be given to all during the session and for the area session is taking place, including: group manager/leaders, librarians, peers, and library environments.
4. Cell phones are turned into group manager(s) upon entering group session (in -person).
5. Parents should contact group manager in the event of an emergency.
6. Field trip notices must be signed and turned in before the trip and before the student may board the bus.
7. Participant must complete assigned homework in order to participate in social activities and as requirement  
in the event they are winner of prize or reward.
8.  Parents will encourage kids to participate and remain timely to sessions in person or electronic/media based.
9. No more than 1 absence is permitted during a  session or automatic withdrawal or forfeit of prizes/rewards.
10. No recording or pictures of sessions at anytime.
11. Parents/Adults are not to join youth sessions (please be respectful of youth social and learning space).
12. Parents are not to record or photograph any child during sessions.
13. No leaving or wondering around during session or field trips (including breaks).
14. If participants want to remain at the library outside of meeting times he/she shall still uphold the values of Key 2 Success, and continue best behavior practices to avoid a withdrawal.
15. Parents will be engaged to maintain child’s obligations: engagement includes making sure they are completing work hours, being respectful, on time, and field trip notices signed on time.
16. Parents will be fully engaged to ensure participants obligations are met, as well as, responding to emails, coming to parent info session, and encouraging participation!!!

Please, sign below to agree that you have read and fully comprehend the rules and regulations of Key 2 Success and will adhere to such rules/regulations while in this program:

Please Certify, That the person filling out this form is the Guardian (Adult over 18yrs) of participant seeking sign -up (Enter Name Full Below) *
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