Student to Student Permission Slip 2025-2026

Student to Student Electronic Permission Slip

* Student Leader's Name

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Inputting your name below is equivalent to a signature, indicating that you understand and agree to the following sections:

The student and parent/guardian authorize the student to participate in the voluntary community service activities of the Jewish Community Relations Council's Student-to-Student Program.

* Parent/Guardian Signature

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* Student Signature

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* Medical Attention

The advisor IS authorized to seek medical attention for my child in case I cannot be reached

The advisor IS NOT authorized to seek medical attention for my child in case I cannot be reached

By presenting in the Student to Student program, our students are at their own risk for COVID-19 or any other airborne illnesses that may be present/ in season in a classroom or presentation space.

* Best phone number where a parent or guardian can be reached:

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* Travel (please check all that apply)

I give my permission for my child to drive themself

I give my permission for my child to drive and to take other students as passengers

I give my permission for my child to be driven by another student or an adult advisor or parent

Photo/Video Release

I give permission for my child to be in photos, videos, social media posts, or articles to be used in connection with the Student to Student program

I DO NOT give permission for my child to be in photos, videos, social media posts, or articles to be used in connection with the Student to Student program

Each academic year, 100+ Jewish teens participate in Student to Student to build bridges and confront antisemitism.

JCRC invests approximately $600 into each teen, each academic year. While some of this is defrayed by donations to Student to Student and other funding, a $180 participation fee (tax-deductible) is requested from each family of an enrolled Student Leader, for each year they participate.

Click here to fulfill this participation fee --> http://weblink.donorperfect.com/STSfamilies

If you have any further questions, please contact Director of Student to Student, Lauren Abraham at labraham@jcrcstl.org

Don't forget to hit submit on this electronic permission slip!

SUBMIT