Doc2

PARENT/GUARDIAN CONSENT FOR RELEASE OF EDUCATIONAL INFORMATION In accordance with the Federal Educational Rights and Privacy Act ("FERPA"), and related state law as set forth in FS §1002.22 and FS §1002.221, | hereby consent to the release of my child's educational records, including reports, test scores, and related information, to the program staff at Champions for Learning to assist with monitoring my child's academic progress in order to help identify any areas of academic need for my child so that it can provide appropriate enrichment programs as needed. Student's Name School Student ID Number Grade Parent/Guardian Name: Signature of Parent/Guardian: DATE The Education Foundation of Collier County www ChampionsForLearming.org 3606 Enterprise Avenue, Suite 150, Naples, FL 34104 2396434755 phone 2396424799 fax