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THE M.P. EMPOWERMENT ACADEMY

Participant Registration

THE M.P. EMPOWERMENT ACADEMY

PARENT/GUARDIAN CONSENT FORM

I, the parent or legal guardian for participant(s) listed above, hereby give my permission for my child to participate in the Mentoring Program at the M.P. Empowerment Academy hosted by What Would Marcus Do.


I fully understand that the program involves instructors and mentors, who shall be selected from the community and will be properly screened and trained before beginning in the program. I also understand no instructor, mentor, or What Would Marcus Do representative is not allowed to take or meet my child beyond the Hilltop Library or designated supervised meeting areas.


I understand that my child will participate in an orientation session in which the program will be explained. The program is planned to last on specific dates as outlined above.


I understand that during the course of the program there may be special group events (incorporating all mentors and youth) and family events planned. I understand that the staff of What Would Marcus Do will provide ongoing monitoring of the mentoring activities.


I also hereby permit What Would Marcus Do by way of The M.P. Empowerment Academy to utilize photographs of my child taken during his/her involvement in the program and waive all rights of compensation.

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CONTACT US

5820 Sullivant Ave. #152 Galloway, OH 43119

Phone:  614.969.7765 

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