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East Palo Alto Tennis and Tutoring (EPATT) Program 

Consent Form

2023 - 2027






Updated: 9/1/2025

EAST PALO ALTO TENNIS & TUTORING (EPATT) PROGRAM 2023-2027

CONSENT FORM

I give permission for my child(ren) to participate in the East Palo Alto Tennis and Tutoring program. I hereby to authorize EPATT staff to arrange for transportation of my child(ren) to the closest hospital in case of accident or illness. I understand that an effort will be made to notify me before such action is taken and the expenses of these services and any subsequent medical expenses will be assumed by me. I give permission for the above-named minor(s) to participate in all EPATT activities and in so doing absolve EPATT, their employees, volunteers, and officers from such liability that may arise as the result of participation. I release and forever discharge EPATT and employees, volunteers, and officers from any and all claims and demands of every kind, nature, and character which may have been or may hereafter be acquired for any and all damages, losses, or injuries which may have been suffered or sustained by my child(ren) in connection with the program activities. I have read, understand, and agree with the statement above:

September 15, 2025

PARENTAL PERMISSION FOR SCHOOL VISITS BY EPATT STAFF AND ACCESS TO STUDENT RECORDS

Dear School Administrator and/or Faculty/Staff,

As part of their child’s participation in the East Palo Alto Tennis & Tutoring (EPATT) program, the parent/guardian of the Student has granted EPATT's staff permission to speak with you about their child’s academic performance, participation, and attendance. Additionally, they have granted permission to EPATT's staff to obtain a copy of their child’s progress reports, report cards, and attendance records. This information will remain confidential and will be used only to monitor their child’s classroom performance and to project performance milestones.

I grant permission to the administrators/faculty/staff at my child’s school to discuss information related to my child’s classroom participation, performance, and/or attendance with EPATT staff. I also give permission to release copies of my child’s, class schedule, progress reports, report cards, transcripts, and attendance records to EPATT's staff. Please contact me if you have any questions. Thank you. 


MEDIA RELEASE FORM

Photo, Video, and Audio Recording Release for Person(s) Under 18 Years of Age.

I hereby authorize EPATT to photograph my child(ren) and use their photographs or other reproductions of their likeness for print, digital or online publication purposes.

I hereby authorize EPATT to videotape or audio record my child(ren). These videos and recordings may be used for promotional or publicity purposes and published online or played on radio or television broadcasts. Additionally, I authorize the use of my child(ren's) name in these broadcasts and videos.

This release is effective until revoked in writing by the undersigned. Such revocation shall only be effective to prevent any expanded future use of the recordings. 


NEXTIVA PHONE SERVICE PARENTAL CONSENT

I hereby authorize EPATT to subscribe me as a member of Nextiva services. I hereby consent EPATT to send voice and SMS/MMS text messages through the Nextiva services. Message frequency may vary, and standard message and data rates may apply. No mobile or messaging consent information will be shared with third parties/affiliates for marketing/promotional purposes. All the above categories exclude text messaging originator opt-in data and consent; this information will not be shared with any third parties. Reply HELP for help or STOP to unsubscribe.



EZ-TEXT MESSAGING SERVICE PARENTAL CONSENT

I hereby authorize EPATT to subscribe me as a member of EZ Texting services. I hereby consent EPATT to send voice and SMS/MMS text messages through the EZ Texting services. Message frequency may vary, and standard message and data rates may apply. Reply HELP for help or STOP to unsubscribe.



EPATT PRIVACY POLICY

1. Introduction

East Palo Alto Tennis & Tutoring is a 501(c)(3) nonprofit organization committed to serving youth ages 5-18 through online tutoring and in-person tennis instruction. We are dedicated to protecting the privacy and personal information of our participants and their families. This policy outlines how we collect, use, store, and protect personal information in compliance with applicable privacy laws, including the Children's Online Privacy Protection Act (COPPA) and state privacy regulations.

2. Information We Collect

2.1 Student Information

  • Registration Data: Name, date of birth, grade level, school attended, parent/guardian contact information
  • Academic Information: Learning goals, subject areas, academic progress, assessment results
  • Health & Safety Information: Emergency contacts, medical conditions affecting participation, dietary restrictions or allergies
  • Participation Records: Attendance, session notes, behavioral observations, achievements

2.2 Parent/Guardian Information

  • Contact Information: Names, phone numbers, email addresses, mailing addresses
  • Emergency Information: Alternative contacts, medical insurance information
  • Communication Preferences: Preferred contact methods and frequency

2.3 Technical Information (Online Tutoring)

  • Platform Usage Data: Login times, session duration, technical performance metrics
  • Educational Content: Assignments, homework submissions, digital worksheets, progress tracking
  • Communication Records: Chat logs, video call recordings (when enabled), email correspondence, digital whiteboards, tutoring session logs

2.4 Photos and Videos

  • Promotional Materials: Photos/videos of activities for marketing and fundraising purposes
  • Documentation: Progress documentation, achievement recognition
  • Security: Facility security camera footage (tennis facilities only) - kept by the Ravenswood City School District

3. How We Use Information

3.1 Educational Services

  • Provide personalized tutoring and tennis instruction
  • Track academic and athletic progress
  • Communicate with parents about student development
  • Customize learning experiences to individual needs

3.2 Safety and Operations

  • Ensure student safety during all activities
  • Maintain emergency contact capabilities
  • Comply with facility insurance and liability requirements
  • Conduct background checks on staff and volunteers

3.3 Program Improvement

  • Evaluate program effectiveness
  • Generate anonymized reports for funders and stakeholders
  • Conduct research to improve our services (with appropriate consent)

3.4 Communication

  • Send program updates and announcements
  • Share student achievements (with permission)
  • Provide educational resources to families

4. Information Sharing and Disclosure

4.1 We DO Share Information With:

  • Staff and Tutors: Only information necessary to provide services
  • Emergency Services: When student safety is at risk
  • Legal Authorities: When required by law or court order
  • Insurance Providers: For liability and coverage purposes
  • Technology Vendors: Third-party platforms used for online tutoring (subject to data processing agreements)

4.2 We DO NOT:

  • Sell student or family information to third parties
  • Share information for commercial marketing purposes
  • Use student data for purposes unrelated to our educational mission
  • Share information with other organizations without explicit consent

5. Data Security Measures

5.1 Technical Safeguards

  • Encrypted data transmission and storage
  • Secure, password-protected systems
  • Regular security updates and monitoring
  • Limited access controls based on job responsibilities

5.2 Physical Safeguards

  • Locked filing cabinets for paper records
  • Restricted access to areas containing sensitive information
  • Secure disposal of documents containing personal information

5.3 Administrative Safeguards

  • Staff training on data privacy and security
  • Background checks for all personnel with access to student information
  • Regular review and update of privacy practices

6. Parental Rights and Choices

6.1 Access and Review

Parents/guardians have the right to:

  • Review their child's records maintained by our organization
  • Request corrections to inaccurate information
  • Receive copies of their child's information (reasonable fees may apply)

6.2 Consent and Control

  • Photo/Video Consent: Separate consent required for use in promotional materials
  • Communication Preferences: Choose how and when to receive updates
  • Data Sharing: Opt out of non-essential information sharing
  • Account Deletion: Request removal of student information when services end

6.3 COPPA Compliance (Children Under 13)

  • We obtain verifiable parental consent before collecting personal information from children under 13
  • Parents can review, delete, or refuse further collection of their child's information
  • We collect only information necessary to provide our educational services

7. Data Retention

7.1 Active Participants

  • Student records maintained throughout enrollment period
  • Academic progress tracked for continuity of services
  • Safety and emergency information kept current

7.2 After Program Completion

  • Essential records retained for 3 years for alumni services and program evaluation
  • Financial records retained as required by law (typically 7 years)
  • Photos/videos retained until consent is withdrawn
  • Academic records available for former students upon request

7.3 Secure Deletion

  • Information securely deleted according to established schedules by parental request
  • Digital data permanently removed from all systems by parental request
  • Physical documents shredded or destroyed by parental request

8. Third-Party Services

8.1 Online Tutoring Platforms

We may use third-party platforms for online tutoring services. These providers:

  • Must comply with COPPA and other applicable privacy laws
  • Are bound by data processing agreements limiting use of student information
  • Cannot use student data for their own commercial purposes

8.2 Current Third-Party Providers

  • Clever
  • PencilSpaces
  • Achieve3000
  • IXL

9. Policy Updates

We may update this privacy policy as our services evolve or laws change. We will:

  • Notify parents/guardians of significant changes
  • Post updated policies on our website
  • Provide at least 30 days' notice before material changes take effect
  • Obtain new consent when required by law


For Parents/Guardians

By signing below, I acknowledge that I have read and understood this Data Privacy Policy. I consent to the collection, use, and sharing of my child's information as described in this policy.

 September 15, 2025


First Participant's Name
First Name*
Last Name*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
First Participant's Signature*
Second Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Third Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Parent or Guardian's Email Address
Email*
Confirm Email*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name
First Name*
Last Name*
Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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