Terms and Conditions

Waiver (Medical Release and Parent Authorization)

Authorization for Academic Reports

As parent/guardian of a Midtown-Metro student, I give permission for information such as quarterly grades and progress reports to be shared with Midtown and/or Metro. I understand that this agreement will be in effect each year for the length of time that my child is a Midtown-Metro student. Copies of all progress reports and report cards should be sent directly to: Metro Achievement Center for girls at 310 South Peoria, Chicago, IL 60607 or by fax to 312-226-6545 OR Midtown Center for boys at 1819 N. Wood St. Chicago, IL 60622 or by fax to 773-292-0203.

Transportation

For students enrolled in the Midtown/Metro Achievement Program [grades 7 and 8] and College Orientation Program [high school], I grant Midtown/Metro permission to dismiss my child, allowing him/her to take public transportation home without a guardian present. Exceptions will be made only by written request of the parent or guardian.

Students enrolled in the One-on-One Program (grades 4 through 6) must be picked up by a parent, guardian or family member. Exceptions will be made only by written request of the parent or guardian.

Medical Release Waiver

In case of emergency, I hereby grant permission for the Metro Achievement Center for girls/Midtown Center for boys or any successor organization, its officers, employees, representatives, agents or volunteers ("Provider") to consent on my behalf to the administration of emergency medical treatment and/or any assistance necessary for the health and welfare of my minor child, including the transportation by Provider's staff members and/or its representatives, whether paid or volunteer, to any health care facility or hospital, or the procuring of an ambulance, and I agree to indemnify and hold Provider harmless from any liability claim arising therefrom, including the payment of any attorney's fees or court costs.

I further understand that Provider's staff members are not physicians or medical practitioners of any kind. Nevertheless, I hereby release the Provider and Provider's staff to render temporary first aid to my minor child and agree to indemnify and hold them harmless for any liability arising therefrom, including the payment of any attorney's fees and court costs.

This Authorization and Release shall remain valid until expressly revoked. I agree that it is my sole responsibility to update the information contained herein. I agree that I will be responsible for the payment of any and all medical services rendered.

Parent Responsibility Policy

The Midtown-Metro programs operate on the principle that parents are the primary educators of their children. Midtown-Metro believes that continual parental involvement is crucial to the success of any educational program. Therefore, in order to be considered for admission to a Midtown-Metro program, each parent must agree to and comply with the following criteria, both for the parent and the applicant child.

I/We (as the responsible parent) will attend a minimum of one parental workshop, seminar, or class per school year.

I/We have received, read, understand and agree to comply with the Midtown-Metro Policy

Guidelines for Parents and Students regarding Attendance, Discipline, Computer Use, Dress Code, Field Trips, Photos, and the Tutor/Student Relationship policies of Midtown-Metro. By signing this application form I agree to the terms and conditions above and verify and attest to the fact that all information presented on this application is complete and factually correct. By this submission I wish my son/daughter to be considered for participation in one of Midtown-Metro's programs and, if accepted, I agree to fulfill my financial obligation to Midtown-Metro.

Applications must be completed and submitted to the appropriate Midtown-Metro

program on a timely basis in order to be considered for acceptance. I further understand that the submission of an application is not a guarantee that my child will be accepted for the program, his or her admission for either program is entirely at the sole discretion of the Midtown-Metro staff.