Online Tutoring Application Tutoring Online ApplicationDatePARTICIPANT’S INFORMATIONFirst NameLast NameDate of Birth Food AllergiesSchoolGrade/GradoTeacherPARENT/GUARDIAN INFORMATIONPhoneAlternate Phone NumberEmailTUTORING SITEPlease choose your preferred Site & Day for tutoring.Dropdown- Select -Mondays | Brown Hutchinson MinistriesWednesdays | Tabernacle Community ChurchLIABILITY RELEASE / KUBONA INSHINGANOYou must agree to the following terms and conditions by clicking the check box. ENGLISH I, the undersigned, agree to save and hold harmless Positive Impact for Life and respective departments, organizations, boards, commissions, officers, agents, and employees and contractors from any liability whatsoever for any harm, personal injury, or property damage which I or my child may cause or suffer arising out of his/her participation in the Positive Impact for Life Tutoring Program. SWAHILI Jyewe, abashyizweho umukono, nemeye kuzigama no gufata Ingaruka zitagira ingaruka ku buzima no mu mashami, amashyirahamwe, inama, komisiyo, abayobozi, abakozi, n'abakozi ndetse naba rwiyemezamirimo ku buryozwe ubwo ari bwo bwose ku byangiritse, ibikomere ku giti cyanjye, cyangwa ibyangiritse ku mutungo njye cyangwa cyangwa umwana wanjye arashobora gutera cyangwa kubabara biturutse ku ruhare rwe muri Ingaruka Nziza Kubuzima bwo kwigisha.PHOTO RELEASE / FOTO YASOHOTSEYou must agree to the following terms and conditions by clicking the check box. ENGLISH I grant to the Positive Impact for Life Tutoring Program, its representatives and employees the right to take photographs of my child. I authorize the Positive Impact for Life Tutoring Program, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that the Positive Impact for Life Tutoring Program may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content. I have read and understand the above. SWAHILI Ntanze Ingaruka Nziza kuri Gahunda yo Kwigisha Ubuzima, abayihagarariye n'abakozi uburenganzira bwo gufata amafoto y'umwana wanjye. Nemereye Ingaruka Nziza Kubuzima bwo Kwigisha Ubuzima, inshingano zayo no kwimura uburenganzira, gukoresha no gutangaza kimwe mubicapuwe na / cyangwa kuri elegitoroniki. Nemera ko Ingaruka Nziza Kubuzima Gahunda yo kwigisha irashobora gukoresha amafoto yanjye hamwe nizina ryanjye cyangwa ntarizina ryanjye kandi kubwimpamvu iyo ari yo yose yemewe, harimo nkurugero nko kumenyekanisha, gushushanya, kwamamaza, nibirimo kurubuga. Nasomye kandi ndumva ibyavuzwe haruguru: STUDENT BEHAVIOR CONTRACT / AMASEZERANO Y'ABANYESHURIYou must agree to the following terms and conditions by clicking the check box. ENGLISH To ensure the safety of myself and others, I agree to follow the rules of the school and the instructions given by the Positive Impact for Life Tutoring staff. I will arrive on time to all after school sessions. I will tell Positive Impact for Life Tutoring staff if I cannot attend one of the sessions. If I have more than 3 unexcused absences in the program during the school year, I will risk expulsion from the program. I have read and understand the above. SWAHILI Kugirango umutekano wanjye hamwe nabandi, nemeye gukurikiza amategeko yishuri hamwe namabwiriza yatanzwe ningaruka nziza kubakozi bashinzwe ubuzima. Nzagera ku gihe kuri bose nyuma yamasomo. Nzakubwira kubyerekeye Ingaruka Nziza Kubakozi Batoza Ubuzima niba ntashobora kwitabira kimwe mu masomo. Niba mfite inshuro zirenga 3 zidahari muri gahunda mugihe cyumwaka w'amashuri, nzagira ibyago byo kwirukanwa muri gahunda. Nasomye kandi ndumva ibyavuzwe haruguru: Click the Following Checkbox to Prove You Are Not a BotSubmit Form Sorry, but we are no longer accepting applications at this time. Tutoring Online ApplicationDatePARTICIPANT’S INFORMATIONFirst NameLast NameDate of Birth Food AllergiesSchoolGrade/GradoTeacherPARENT/GUARDIAN INFORMATIONPhoneAlternate Phone NumberEmailTUTORING SITEPlease choose your preferred Site & Day for tutoring.Dropdown- Select -Mondays | Brown Hutchinson MinistriesWednesdays | Tabernacle Community ChurchLIABILITY RELEASE / KUBONA INSHINGANOYou must agree to the following terms and conditions by clicking the check box. ENGLISH I, the undersigned, agree to save and hold harmless Positive Impact for Life and respective departments, organizations, boards, commissions, officers, agents, and employees and contractors from any liability whatsoever for any harm, personal injury, or property damage which I or my child may cause or suffer arising out of his/her participation in the Positive Impact for Life Tutoring Program. SWAHILI Jyewe, abashyizweho umukono, nemeye kuzigama no gufata Ingaruka zitagira ingaruka ku buzima no mu mashami, amashyirahamwe, inama, komisiyo, abayobozi, abakozi, n'abakozi ndetse naba rwiyemezamirimo ku buryozwe ubwo ari bwo bwose ku byangiritse, ibikomere ku giti cyanjye, cyangwa ibyangiritse ku mutungo njye cyangwa cyangwa umwana wanjye arashobora gutera cyangwa kubabara biturutse ku ruhare rwe muri Ingaruka Nziza Kubuzima bwo kwigisha.PHOTO RELEASE / FOTO YASOHOTSEYou must agree to the following terms and conditions by clicking the check box. ENGLISH I grant to the Positive Impact for Life Tutoring Program, its representatives and employees the right to take photographs of my child. I authorize the Positive Impact for Life Tutoring Program, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that the Positive Impact for Life Tutoring Program may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content. I have read and understand the above. SWAHILI Ntanze Ingaruka Nziza kuri Gahunda yo Kwigisha Ubuzima, abayihagarariye n'abakozi uburenganzira bwo gufata amafoto y'umwana wanjye. Nemereye Ingaruka Nziza Kubuzima bwo Kwigisha Ubuzima, inshingano zayo no kwimura uburenganzira, gukoresha no gutangaza kimwe mubicapuwe na / cyangwa kuri elegitoroniki. Nemera ko Ingaruka Nziza Kubuzima Gahunda yo kwigisha irashobora gukoresha amafoto yanjye hamwe nizina ryanjye cyangwa ntarizina ryanjye kandi kubwimpamvu iyo ari yo yose yemewe, harimo nkurugero nko kumenyekanisha, gushushanya, kwamamaza, nibirimo kurubuga. Nasomye kandi ndumva ibyavuzwe haruguru: STUDENT BEHAVIOR CONTRACT / AMASEZERANO Y'ABANYESHURIYou must agree to the following terms and conditions by clicking the check box. ENGLISH To ensure the safety of myself and others, I agree to follow the rules of the school and the instructions given by the Positive Impact for Life Tutoring staff. I will arrive on time to all after school sessions. I will tell Positive Impact for Life Tutoring staff if I cannot attend one of the sessions. If I have more than 3 unexcused absences in the program during the school year, I will risk expulsion from the program. I have read and understand the above. SWAHILI Kugirango umutekano wanjye hamwe nabandi, nemeye gukurikiza amategeko yishuri hamwe namabwiriza yatanzwe ningaruka nziza kubakozi bashinzwe ubuzima. Nzagera ku gihe kuri bose nyuma yamasomo. Nzakubwira kubyerekeye Ingaruka Nziza Kubakozi Batoza Ubuzima niba ntashobora kwitabira kimwe mu masomo. Niba mfite inshuro zirenga 3 zidahari muri gahunda mugihe cyumwaka w'amashuri, nzagira ibyago byo kwirukanwa muri gahunda. Nasomye kandi ndumva ibyavuzwe haruguru: Click the Following Checkbox to Prove You Are Not a BotSubmit Form