• Lead The Way Learning Academy 2020-2021 Learning Zone Release of Information

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  • Release of Information

  • 1. I understand recorded images of my child (both visual and audio) may be made of my child during the program. I give permission to Lead The Way Learning Academy, its designees, and its partner agencies providing services during the program to make and use such images/recordings in publications, advertising, brochures, newspapers, website or other advertising medium. I hereby waive any right to inspect and/or approve the finished product or the advertising copy that may be used, and the use in which it might apply from all legal responsibility or liability for the use of photographs as authorized herein. I also agree to release and hold harmless LTWLA and any third party it has approved from and against all claims, demands, damages, and liabilities arising out of the recording.

  • 3. I give permission for my grades K-8th grader to view G and PG movies.

    4. I give my child permission to use the Internet and other forms of technology in the program.

    5. I give permission for the program staff to release any confidential information involving my child with other providers, school personnel including the school nurse and Law Enforcement. I understand that the program staff are mandatory reporters for the Department of Children Services.

    6. I give permission for the program staff to have access to my child’s 504 and/or Individualized Education Program (IEP) and to discuss his/her educational needs with school personnel.

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  • Release of Liability

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  • Permission to Use Educational Data from School and Partners

  • As a parent/guardian of      I grant the school permission to share my child’s school information (i.e. attendance, behavior, grades, standardized test scores, etc.) with Lead the Way Learning Academy to benefit growth and education within the community and classroom settings. I allow representatives of Lead The Way Learning Academy to discuss this information as well as related non-academic information that supports the goals defined above, with school officials and approved representatives of other agencies that have consent.

    This information will only be shared with relevant program staff who have received confidentiality training or until I, the parent/guardian, revoke this permission in writing to Loren Carter, Program Manager at loren@leadthewaylearningacademy.org or 6600 Busch Blvd, Columbus, OH 43229. 

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  • Permission to Evaluate Programs and Track Student Progress

  • I hereby grant permission for Lead The Way Learning Academy to share my child’s program information (name, date of birth, student ID) with Ohio Department of Education, Franklin County Jobs and Family Services, and United Schools Network. I understand that information will only be shared about my child if it is relevant to my child’s education. The community program may also request access to my child’s academic, attendance and behavior records for the current, prior, and future school years at Columbus City, Westerville, Worthington and other pertinent school districts so that they can provide better services to my child and understand the impact of this program. I understand that this information will be kept confidential. I understand I am able to revoke the consent at any time in writing.

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  • Student Release/Pick Up Policy

    As parent/guardian, I understand that the program times are: 8 am – 3:30 pm *times are subject to change If/When schools resume an in-person setting, the program will begin immediately after school and will end no later than 6:00 p.m. Unless otherwise directed by parent(s) or guardian(s), students will not be released to go home from the program until they are signed out by the parent/guardian or one of the individuals listed below: When I am unable to pick my child up, I give the program staff permission to release my child to:
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  • Permission to Walk Home

  • I give permission for my child to walk home from the program on the following days: .

  • I give permission for Lead The Way Learning Academy staff to release my minor child to into the custody of his/her minor sibling from the program. Minor child’s name is _ .

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  • Notice Regarding Non-Supervision of Children during Virtual Programming & Online Safety

  • LTWLA staff will interact with student via live video sessions, individual and group phone calls, messages, in-person visits and other means. No LTWLA staff or LTWLA partner assumes responsibility for supervision and care of your child during the program. No LTWLA staff member may orally waive this prohibition. This is a significant difference from the caretaker relationship inherent in our in-person programs and programs of prior years.

    While Ohio does not have a law regarding the minimum age a child may stay home alone, Lead the Way recognizes advice of leading experts, including Nationwide Children’s Hospital, indicating that children 12 and under should be consistently supervised by a responsible caregiver. As the parent or legal guardian, you remain responsible for supervision of your child at all times during his or her participation in the program regardless of location.

    The program uses virtual online platforms to provide content and communicate with your child. Primary platforms include Zoom, Facebook, Instagram, Google Hangouts, House Party, and Kahoots (others platforms may be used in the future). Any online platform has risks for a child. While LTWLA continually investigates best practices and takes steps to protect each participant, parents and guardians must retain primary responsibility for protecting their child while online during program activities. Security features of online platforms change regularly and best practices continue to emerge during this unprecedented time.

    Devices loaned by LTWLA for the program allow for full internet access. The devices do not have built-in safeguards that prevent children from using it for inappropriate or dangerous purposes. Each parent or guardian who accepts a loaned tablet should have a plan for monitoring its use and preventing inappropriate use.

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  • Acknowledgement of Non-Supervision of Children during Virtual Programming

    I recognize that the program may be all or substantially virtual due to the COVID-19 pandemic. I acknowledge that I am solely responsible for supervision and care of my child during the virtual program, and will not rely on Lead The Way Learning Academy’s staff to supervise or monitor my child’s activities at home or online. I will discuss online safety with my child and monitor his/her use of platforms and devices used during the virtual program. I will also have my child complete the SMART Safe Surfing Agreement.
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  • Permission for Participation in Electronic and In-Person Activities

  • In consideration of the opportunity for my child to participate in the program offered by Lead the Way Learning Academy (LTWLA) and its partners, I, the parent or legal guardian, give my permission for each of the following activities and grant LTWLA the irrevocable right to use of data as follows:

    • I give permission for LTWLA staff to email, chat, text, and engage with my child through social media as part of program activities. These communications may involve one-on-one, group, individual, private or public. 
    • I recognize that during program video communications, the environment each child is in (home or elsewhere) will likely be visible to all participants. Virtual backgrounds may reduce this visibility, but are not fail-safe. 
    • I acknowledge and consent that video sessions be recorded and saved on LTWLA staff devices and the cloud. These records may include protected personal information such as children’s names, nicknames, email addresses, usernames, geo-location information, photos, video, and audio files of the child. I understand that any person on a video call may be able to record, capture screen shots, take pictures or otherwise record any part of the session.
    • I consent for my child to chat privately with other children and *adults present on the video call, email or cell phone communication conducted during Summer Learning Zone activities. *LTWLA staff and counselors (adults) have successfully passed the BCI/FBI backgrounds and National Sex Offender Registry checks. At no time will our staff interact with your child outside of Summer Learning Zone hours/parameters. 
    • I grant permission for LTWLA and its partners to use my child’s name, likeness, work, writing and voice in keeping with LTWLA policies and mission.
    • I grant LTWLA unqualified permission to use, reproduce, share, distribute, publicly display and publicly perform recordings of my child in whole or part worldwide, without restrictions or limitations, in perpetuity, for any purpose related to LTWLA’s mission, including without limitation, sharing with stakeholders, seeking funding, and other promotional, research, training or educational purposes. My child’s image, name, voice and personal data may be presented via any media existing now or in the future without further permission or notice to me. 
    • I agree to release LTWLA and its trustees, officers, employees, students, volunteers, and agents from any liability to me, and on behalf of my heirs, executors, administrators, legal representatives and assigns, based upon or arising out of use of my child’s name, likeness, voice, personally identifiable data or the recordings. 
    • I agree to make no accounting, monetary or other claim against LTWLA for use of my child’s name, likeness, voice, statements or recordings.
    • This release shall be governed in accordance with the laws of the State of Ohio. 
    • I have read this Release Form and understand its terms. I sign it voluntarily and agree to be legally bound by its terms.
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  • Lead The Way Learning Academy 2020 Summer Summer Learning Academy

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