Appendix A. lowit 10 your child's Senior English Academie Partner. Parent/Guardian/Student Permission and Liability Form Thave read the Letter to Students and Families relating to the Pride Project and understand thatthe satisfactory completion of the research paper, 10 project hours, product, and presentation are required to graduate and receive a diploma from Pine Lake Preparatory. I also understand that the student and his / her parents are responsible for any damage or injury to the student or others during the student's self-selected Pride Project hours. I 1 Parent/Guardian Name(s) please prt) (Clare n- Benton [hoo Balle eat Cot Parenv/Guartin Home Phones): "104 - YA -BIUS| JOA- 351-489 Work Phone(s): JOU-974-Al (oS money 04251-9484 rather) ParenvGuardian Emait: Oink be 5S S i - 60.0 Parent/Guardian Signature | | LOU vy- x 4 hi tan pate “1 {10 | 1S t o (2 Signature Optional) Date Student Signature Notopun eu tetuy Date 1/10 //sAppendix © Mentor Consent Form The role of the Mentor is to serve as an expert in the field chosen by the student. By signing this form, the Imentor agrees to: allocate time (a minimum of ten hours) to work with the student; provide insight into the training, expectations, and demands of the field; ensure thatthe student is actively involved during shadowing ‘and not simply observing. If desired, the mentor may provide suggestions, advice, and support regarding the ‘development of a tangible product that connects to the real-world requirements of the career. Student Name [Y\oC0n Baie. Project Topic Devntzal try a eine Mentor Name _D¢ Place of Employment Dawn _S. (Wall\ act General and Cosmet Deninsty Work Address 44] _Wi\liamsom Road, Suite 205 Mooresville NC 2817) Preferred Email Preferred Phone ‘Occupation / Title / Expertise Related to Topic __ ‘Years of experience in topie area For the protection of myself and the student, I agree that we will not meet alone. T agree to uphold the roles/duties of the project mentor a yy ability. I also confirm that | am not related to the student. sa ee ae agus ae J-14-/5 parent Signore _(YVVCitn Ora felts pae 415-15 u Student Signature Oa Berkley ae 4-19-18