Raise Youth Mentoring - Consent Form

Dear Parent / Carer,

Raise would like to invite your child to participate in our Youth Mentoring program which will run at your child's school this year.

The program matches volunteer mentors with students for mentoring for the duration of the program. This program can be delivered both face-to-face at the school or via our secure Zoom online platform.

You should already have received some information about this opportunity from your school.

Any online delivery will be conducted safely in conjunction with the school and in adherence to the Raise Code of Conduct and Youth Safety Framework.

Participation in this program includes participating in evaluation data collection activities, including, but not limited to surveys (via online survey tool) and may include a focus group at the school. The results of the program evaluation are used to help improve the program for the following year and measure its impact. You can find examples of questions here.

Raise may use the details provided in the surveys or focus groups in communications about program experience. Where this occurs, any identifying details will always be removed to protect the privacy of students and ensure an individual student's experiences cannot be recognised. Or attributed to them.

To allow your child to participate in the program, please complete the form below.

Participation is not permitted without a consent form and places are limited.

Student First Name

Student Last Name

School Name

Student Email Address

This email address may be used to send digital evaluation surveys to your child to complete

Student DOB

Year at School

Student Home Address
This address will be used if materials need to be sent to the student, especially in the event of COVID 19 restrictions preventing school attendance

Street Address

City

State

Post Code

The following information will help us to understand more about your child and better support them. We will not share this individual information publicly.

Does your child have a disability or have any access needs that we will support?

Does your child identify as an Aboriginal or Torres Strait Islander person?

What country was your child born in?

Does your family speak any languages other than English at home?

Parent/Carer First Name

Parent/Carer Last Name

Parent/Carer Mobile

Parent/Carer Email

Photography - including social media, e-newsletters, internal documents, presentations to Raise partners, the Raise website and other communications for Raise marketing and communication purposes.

Yes, I give consent to my child being photographed and/or filmedNo, I do not give consent to my child being photographed and/or filmed

Please tick all that apply

Social media e-newslettersExternal presentationsInternal presentations and documentsMarketing and promotional material (including brochures, handbooks, flyers, posters, website)

A light morning/afternoon tea is provided, please detail any allergies and/or dietary requirements your student may have below:

Allergies / dietary requirements

YesNo

A light morning/afternoon tea is provided, please detail any allergies or intolerances your child may have below:

Program ID

Program Cohort ID

Program Engagement ID

By signing and returning this form, I consent to my child participating in the Raise Youth Mentoring program and understand that Raise Foundation may contact myself or my child in accordance with their Privacy Policy.

Once you select the Submit button, you'll be prompted to sign the form - after completing the signature panel, please ignore the red 'incomplete response' box and click the button to Submit Signed Response.