PowerUp for Middle School Consent Information

By indicating your consent for your child to participate in the PowerUp for Middle School program while registering online, you verify the following:

1.    You are the parent or guardian of the child registered to participate.

2.    You have reviewed the detailed curriculum on the program page of the website, have read all the consent information here, and have no concerns about your child learning about listed topics and other related topics.

3.    Your registered child is a 6th grade girl.

4.    You understand that this program’s purpose is only educational and not therapeutic. If program facilitators identify a need that may benefit from psychological evaluation or therapy, referral information but not therapy will be given.

5.    You understand the following rules for participant conduct that will optimize the learning experience: respectful, nondisruptive behavior, following program facilitator directions, and keeping cellphones on silent and in a pocket or bag. If any of these rules are violated, you will be called to come and pick up your child. If you need to contact your child during programming, please come to or call the Windsor Recreation Center at (970) 674-3500.

6.    You agree to pick up your child each program day by 5:20 PM.

7.    You will not hold program facilitators or the Greeley Recreation Center liable for accidents or injuries.

8.    Your child will be provided food and if she has food insensitivities or allergies, it is her responsibility to ask about ingredients in all food she chooses to ingest, and you have discussed this responsibility with her.

9.    You are aware that program facilitators are mandatory reporters of child abuse and neglect.

10.    You permit utilization of photographs or videos of your child taken during her involvement in the program for promotional purposes and waive all rights of compensation.

11.    One of our goals is to learn how to improve the program and assess how well we provide empowering life-skill education. By consenting, you agree to have your child fill out anonymous surveys during the program. You also allow her to fill out short anonymous surveys at the end of each session indicating things such as understanding of the topics and enjoyment of the activities. You also agree to do a quick online anonymous parent-guardian survey after the program. Lastly, you permit us to use summaries of any survey data or anonymous participant quotes on our website or in print materials, etc.

Click to go back to the registration page.

 The youth Empowerment Group thanks you!