Youth4Good Tutoring Student Application Form

Youth4Good Tutoring Student Application Form

Youth4Good Foundation is a a 501(c)3 non profit organization which aims at developing leadership skills and good citizenship practices in youngsters through community service. Our website is www.youth4good.us. We offer a free online tutoring program devoted to boost students’ confidence in school and improve their academic performance. This is a high quality program offered by caring High schoolers with prior experience in teaching online classes and summer camps. Service includes: A+ homework help and 1:1 Online Tutoring. If you are having any questions, please let us know at tutor_leads@youth4good.us. Thank you.
Student Name*

First NameLast Name
Student Email
example@example.com
Student Phone Number
Please enter a valid phone number.
School Name*
Student Grade*
Parent Name*

First NameLast Name
Parent Email*
example@example.com
Parent Phone*
Please enter a valid phone number.
Emergency Contact's Name*
Emergency Contact's Phone*
Please enter a valid phone number.
What city do you live in? *
Requested Tutoring Subject (High Schoolers: Please choose "Other" and specify your subject in the text)*

Elementary MathMiddle School MathElementary EnglishMiddle School EnglishElementary ScienceMiddle School ScienceProgramming or CodingOther
What is your child interested in?*
This is so our tutors can get to know your student.
Is there anything else we should be aware of? Do you have any preferences for tutors?
How did you hear about us?*

FriendsReturning StudentsSchoolWebsiteKyrosOther
I, the parent and/or legal guardian, hereby represent that I consent to my child or ward's participation in the activities and/or events. I agree individually and on behalf of my child or ward, to WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons including Youth4Good Foundation, and/or their employees, volunteers, officials, sponsors and other representatives. I further agree to hold harmless each and all of the parties referred to above from all liability, loss, cost, claim, or damage whatsoever which may be imposed upon said parties because of any defect in or lack of such capacity to so act and release said parties on behalf of the child or ward and the parents or legal guardians. I hereby authorize and consent to the use of my child/ward's visual image by Youth4Good Foundation for appropriate purposes, including but not limited to: still photography, videotape, electronic and print publications and websites. I give this consent with no claim for payment. Parent are required to be present during the tutoring sessions. I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL.*

I consent to all terms stated above.
Are you an active Youth4Good member?*

YesNo
One Time Donation (Non-Refundable)*
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One Time Donation (Non-Refundable)
We appreciate this one time donation, as this allows us to fund our other community services, such as meal services in homeless shelters, gift drives, and other events. We appreciate your support!

$30.00 Quantity

Total

$0.00
Payment Methods

Fastlane Checkout

Choose from one of the PayPal options to make your payment.

Contact Info

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