Our goal at Leading Youth Through Empowerment is to ensure students have the best opportunities possible
to enter college and then their career. In an effort to support students throughout this process, it is essential
we can work with the students, parents, and the middle and high school directly throughout your child’s time
in middle and high school. Therefore, we are asking for your permission to gain access to academic and
demographic based information regarding your child in efforts to implement proactive measures to ensure
their success.
I hereby authorize my child’s middle and high school and the Delaware Department of Education to release all
academic and demographic records to Leading Youth Through Empowerment regarding my child. Under the
Federal Education Rights Privacy Act (FERPA), I have the right to give consent to the release of my child’s
education records including but not limited to their attendance, state testing scores, academic records
including their grades and report cards, parent/guardian contact information, and student behavior reports.
I also allow members of the Leading Youth Through Empowerment to discuss my child’s grades and progress
with the student’s teachers, counselors, the student directly, and anyone else who may have a direct stake in
my child’s future. I also allow Leading Youth Through Empowerment to discuss my child’s grades and
progress with school leaders, teachers, and guidance counselors in their former middle school. All data will
be maintained in a secure manner in accordance with all applicable federal and state requirements relating to
privacy and confidentiality.
I, the undersigned, do hereby authorize a representative of Leading Youth Through Empowerment to meet
with my child at their school to provide mentoring and tutoring services.
I, the undersigned, do hereby authorize Leading Youth Through Empowerment to use and publish any digital
media (included but not limited to photographs, video, and any other form of media) of my child for
educational, editorial, advertising, trade or any other purpose and in any manner or medium; to alter the same
without restriction; and to copyright the same. I further agree to release Leading Youth Through
Empowerment from all claims and liability relating to said media.
I, the undersigned, authorize Leading Youth Through Empowerment to contact both me and my child via
phone call, text message, and video chat.