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Peer Tutoring Drop-In Permission Form

Program Details

  • Who: 5th and 6th grade students
  • When: Tuesdays & Thursdays, 3:25–4:00 p.m.
  • Where: Sakai Intermediate School (classroom room #229)
  • Tutors: High school youth volunteering their time to support this program
  • Supervision: An adult supervisor will be present at all times, taking attendance and monitoring the program.

Important Notes for Families

  • This is a drop-in program. Youth may attend whenever they need support; attendance is not required every Tuesday/Thursday.
  • When a student signs in, the adult supervisor will expect them to stay in the classroom until 4:00 p.m.
  • If a youth does not follow this expectation and chooses to leave early, the supervisor will contact a parent/guardian or emergency contact directly. However, parents will not be contacted if a youth does not attend. 
  • While the program takes place at Sakai Intermediate School, it is run by Bainbridge Youth Services (BYS).
  • The school district is only providing classroom space and is not responsible for program oversight.
  • BYS will not send notifications or reminders about participation.
If you have questions, please contact Laura Firman at tutoring@askbys.org.

This field is for validation purposes and should be left unchanged.

Youth Information

Youth Name(Required)

Parent/Guardian Information

Parent/Guardian Name(Required)

Emergency Contact

Emergency contact(Required)

Permission & Acknowledgment

By entering my name and the date below, I acknowledge that I have read and understand the information provided about the Bainbridge Youth Services Peer Tutoring Drop-In program. I understand that this program is supervised by an adult and supported by volunteer high school tutors. I give permission for my child to participate in this program, and I understand the expectations regarding attendance, supervision, and responsibility for early departure.