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MENTORSHIP CONSENT FORM

YOUTH LEADERSHIP CLUB - EAST END BOYS CLUB

To Parents and Guardians:

 

The purpose of this form is to inform you about our mentorship program, and to seek your support and permission for your child to participate.

This is an important document. Please review its contents carefully prior to providing permission for your child to participate.

Purpose of the mentorship program:

Our EEBC youth are organized into subunits and partnered with one of our incredible EEBC mentors.

These community leaders range from World Champion Athletes, to school teachers, to former EEBC Alumni, to business leaders and realtors all at the top 10% of their respective industries.

Our EEBC mentors help our youth set goals and keep them surrounded by positive influences on a regular basis by providing the necessary guidance, friendship and support that is needed to lead successful, happy lives. Our EEBC mentors use the framework of Character Counts, The Six Pillars of Character, which include the following themes:

Trustworthiness:

• Honesty

• Reliability

• Loyalty
• Integrity

Respect:

  • The golden rule (Treat others as you would like to be treated)

  • Tolerance and acceptance

  • Non-violence

  • Courtesy

Responsibility:

  • Duty

  • Accountability

  • Pursuit of excellence

  • Self-control

     

Fairness:

  • Justice

  • Respecting the law

  • Openness

 

Caring:

  • Concern for others

  • Being compassionate

 

Charity:

  • Get involved in a cause that you feel strongly about

 

Citizenship:

  • Love for your country

  • Social responsibility

  • Respect the law

Cost:

The cost of the mentorship program is completely covered by the East End Boys Club

All youth who participate in the program are expected to follow and abide by the EEBC Code of Conduct

 

Parent/Guardian Permission:

While staff and mentors will take reasonable steps to prevent injuries to the youth, some degree of risk is inherent in the nature of these activities, and may occur with or without fault on the part of the youth, the EEBC, its staff or agents, or the facility where the activity is taking place. By allowing your child to participate in these activities, you are agreeing that the activities described above are suitable for your child, and that there is a risk of injury associated with the activities.

I hearby grant permission for my child to participate in the EEBC Mentorship program described above. I understand that my child may be exposed to a risk of injury due to accident while participating in these activities.

Mentorship Consent Form