Appendix A
por follows ee oF
P Guardian Permissi Liability F
Thave read the Letter to Students and Families relating to the Pride Project and understand that the 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.
Parent/Guardian Name(s) (please print) J\YY\_SP_A anc j Ru cen
Parent/Guardian Home Phone(s): 04 =()- TY SZ
Work Phone(s): 204-44 7-Ol@ D (Mother) "Zoe(- TA -coQQ® _ (Father)
Parent/Guardian Email(s): ol laBhRnwe 4s
:
Parent/Guardian Signature = — Date_/
(2° Signature Optional) ate 22/1
f
‘Student Signature 1 Date (MeAppendix
Mentor Consent Form
The role of the Mentor is to serve as an expert in the field chosen by the student. By signing tis form, the
mentor agrees to: allocate time (a minimum of ten hours) to work with the student; provide ins
training, expectations, and demands of the field; ensure that the student is actively involved durin
and not simply observing. If desired, the mentor mai
development of a tangible product that connects to the real-world requirements of the career.
Student Name War oun Ru cler
Project Topic “We \ 7
Mentor Name Keat day
Place of Employment “Rows h- Fenw ay Racing :
Work Address DO lac. acecd NC 26027
Pron msi _Sday@) rush Fenway on
Preferred Phone 704 402-5490)
Occupation / Title / Expertise Related to Topic ‘abicke Dy onesie /etegec of Silo
services| 20 years lag wchicle testing € Sinultina Ph.D.in
Years of experience intopic area “BO
For the protection of myself and the student, I agree that we will not meet alone. I agree
roles/duties of the project mentor to the best of my ability. | also confirm that I am not related to the
ht into the
shadowing
provide suggestions, advice, and support rfgarding the
oA
ech. Engineer ia
uphold the
Student.
Mentor Signature Date (Batt2iie
Parent Signature vae 2lo [We
Student Signature Date_/Z, “hte