You may list those who are authorized to pick up your child, as well as those who may not, under any circumstances, pick up your child from Bound Together. If a person who may not pick up your child is a biological parent, we must have a court order signed by a judge to support your request.   Please list each person's name and relationship to student.

We want to inform you and request permission to use your child's photograph/image or a film, video or sound recording of your child on Bound Together's website and in Bound Together's promotional materials or other displays, including but not limited to bulletin boards, wall photographs, posters, brochures, newspapers, magazines, reports or other public documents; or in film, electronic or digital recordings.

Bpund Together will not release any personally identifiable information related to your child. Bound Together will not disclose your child's name or other personally identifiable information for any reason in any public forum.  

As the parent/guardian:  Bound Together NPO requests the use, as described in this document and without identifying information, any photograph, image, film, video or sound recording (otherwise known as “image or recording”)that includes my child. I understand that any image or recording of my child may be used without further consent or authorization from me; that Bound Together may modify the image or recording in the process of editing; and that neither I nor my child am entitled to compensation for use of any image or recording. I also agree to release Bound Together’s board of directors, employees, volunteers and agents from any and all liability arising out of or connected to the use of the image or recording, as stated above. If I, as the parent or guardian, wish to rescind this agreement, I may do so at any time in writing by sending a letter to the director of Bound Together.

ATTENDANCE:  Bound Together’s attendance policy supports three primary goals:
• To build each child’s sense of community with fellow students and volunteers.
• To create consistent educational relationships between students and tutors.
• To give students and tutors the time they need to achieve students’ goals.

In order to create an environment in which we can support success together, we ask parent/guardians to commit to the following:
• That the student(s) will attend regularly:  If  a student misses two program days, excused or unexcused, in any calendar month, enrollment will be reviewed.
• That students will be on time:  Tutoring begins promptly at 4:30.  Students should be dropped off no later than 4:25 in order to facilitate that process.  If your school has a late dismissal we can work that out!
• That students will come prepared to tutor: If there is homework:  they will have it with them. They will know that parent/guardian expects them to participate and follow directions, and they will arrive ready to work.  
• They will be respectful of one another and of  all program volunteers.

ABSENCES:  There will always be times when students might need to miss a program day!  Here’s what we ask:
• If you know that your child will be absent:  please text/call/email  before 1:30 PM on the program day so that we can adjust our tutor schedule accordingly.
• If a student misses two program days without prior notification, enrollment will be reviewed. If there are concerns that are making it difficult to attend:  please discuss with the Director ASAP so that we can find a solution together!
               

In 2023-24, Bound Together plans to prepare snacks and dinners on site, giving us more flexibility and an opportunity to create menus that best serve all of our students.  While not everyone likes everything all the time, we would like to serve students simple, nutritious meals that they enjoy.

With that in mind:  

I understand that my child will be supervised in a public space at all times at Bound Together. Neither Bound Together, nor any member of its staff/volunteers will be held responsible for damages, medical costs or any unforeseen costs that may arise from participation in the program.

I give Bound Together permission to seek emergency medical attention for my child if needed.

All transportation for students is the responsibility of parent/guardians.  Bound Together cannot transport students either from or to home, program or school.

My completion and submission of this form gives Bound Together permission to obtain academic information, including test scores of my child, as well as communication between the principal and teachers. All information thus obtained will be subject to appropriate privacy standards and will not be shared with any other entity.

By completing and submitting this form I certify that all information detailed in this document, Parental/Guardian Contact Info, Emergency Contacts, Image/Recording Consent and Pick-up Release List are accurate and truthful.