Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Student InformationStudent's Name *FirstLastStudent's Date of Birth *Student ID #Parent/Guardian Name *FirstLastParent/Guardian Phone *Parent/Guardian Email *Academic & Media ReleaseAcademic Release *I hereby consent for the release of academic grades, attendance, transcripts, and standardized test scores to Friends and Mentors, Inc.Consent for Photography and Videography *I hereby grant permission for my photo and video to be used by this organization. and Layout Name Date of Consent *Parent/Guardian Signature * Clear Signature Submit
