Project R

Consent Form Portal

Forms Due By: Thursday, March 5, 2026

8 days left

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Welcome to the Project R Consent Form Portal

Please complete all sections below to enroll your student in Project R. All fields marked with * are required. You and your student will each need to provide a signature at the end.

Student & Parent Information

Student Full Name *

Grade *

Parent/Guardian Full Name *

Parent/Guardian Email

Parent/Guardian Phone

Student's School *

Section 1: Photo and Media Consent

Photos and/or videos may be taken during activities to share information about program updates. While every effort will be made to avoid all direct identifying characteristics, some photos and/or videos may incidentally capture participation, whether directly or indirectly. I understand that photos / videos without identifying information may be published through the Lewis University Community School Consortium, Lewis University, Valley View School District websites, and social media.

Please provide your response by checking the appropriate box and writing your initials:

I allow the publication of photographs and/or videos of my child.

I do not allow the publication of photographs and/or videos of my child.

Initials *

Section 3: DuPage Township Minor Release

Parents or legal guardians agree and consent to release and hold harmless DuPage Township from any and all liability, loss, damages, claims, or actions (including costs and attorney fees) for bodily injury and/or property damage, to the extent permitted by law, arising from participation in Project "R" programming.

I understand that participation in Project "R" takes place at the Township administrative building in Bolingbrook and for this reason involves the need for transportation home after the program. The Township will transport my child on their bus. We assume these risks. I hereby consent to emergency transportation and treatment in the event of illness or injury. I hereby accept responsibility for payment of any emergency transportation or treatment on behalf of the participant. I further certify that the participant is in good physical condition, and does not have any medical or physical condition that would restrict his/her being transported by the Township.

I have read, understand, and agree to the DuPage Township Minor Release above.

Section 4: Student & Family Participation Agreement

Please initial next to each list item to show your understanding and agreement of the statement. By signing at the end of this form, you are confirming your agreement to adhere to all expectations of this program.

It is required that the student participant and at least one guardian read and sign this agreement before beginning participation in Project R.

Student Acknowledgments

I agree to actively and productively participate in Project R.

I agree to attend regularly and complete the session activities entirely.

I understand that this program is provided by the Lewis University Community Schools Consortium (LUCSC), in partnership with VVSD.

I understand the Expectations and Guidelines for participation in Project R. I agree to adhere to the standards provided and reviewed per the Expectations and Rules document.

I will uphold the expectations and rules of both Project R and Valley View School District.

I understand that I am responsible for being on time for the program, including (when applicable) arrival to the bus loading area from school to the program site.

I understand that if I do not follow the expectations and rules as reviewed during our intake meeting, then I may be referred to school/district administrators who will determine the appropriate next steps, including and not limited to possible dismissal from Project R.

I understand that LUCSC collects student data to determine program outcomes and to ensure continuous improvement of services provided. All data will be kept confidential between VVSD/LUCSC members, and identifying information will not be published in public spaces. I agree that my educational data may be shared with LUCSC confidentially and securely and used for program evaluation purposes.

I can contact Mr. Cornelius and/or Ms. Smith with questions or if I want to discuss program participation. I have received contact information and know how best to reach the LUCSC (Project R) instructors.

Parent/Guardian Acknowledgments

I understand that my child must productively participate in Project R activities to the best of their ability.

I understand the Expectations and Guidelines for participation in Project R. I will help and support my child, to the best of my ability, to adhere to all Expectations and Guidelines.

I understand that this program is provided by the Lewis University Community Schools Consortium (LUCSC) in partnership with VVSD.

I understand and agree that my child must uphold all expectations and rules of Project R and Valley View School District.

I understand that if my child does not meet expectations, they will be referred to school/district administrators, who may decide to use alternative consequences as appropriate, and that my student may be dismissed from Project R and/or related programming.

I agree that I read and understand the Photo/Video Policy.

I understand that LUCSC collects student data to determine program outcomes and to ensure continuous improvement of services provided. All data will be kept confidential between VVSD/LUCSC members, and identifying information will not be published in public spaces. I agree that my student's educational data may be shared with LUCSC confidentially and securely and used for program evaluation purposes.

I have received contact information and know how best to reach the Project R staff (Mr. Cornelius and/or Ms. Smith). I know that I can contact Mr. Cornelius and/or Ms. Smith with questions, or if I want to discuss program participation.

Section 5: Communication & Technology Consent

Project R utilizes various technology tools to enhance program operations, ensure student safety, and improve family communication. Please review the following information and provide your consent by checking each section.

A. ParentSquare Integration

ParentSquare is the official family communication platform for Valley View School District. Project R will send transportation updates, program announcements, and important notifications through ParentSquare. All ParentSquare messages are automatically translated to your preferred language.

I consent to Project R using ParentSquare to send me program communications and transportation updates.

Initials:

B. GPS Tracking for Transportation Safety

GPS (Global Positioning System) technology allows us to track the real-time location of the bus transporting your child to and from Project R. This includes live bus location tracking, pickup/drop-off time logging, and estimated arrival times. GPS data is only collected during active transport, encrypted, and stored securely.

I consent to GPS tracking of the bus transporting my child to and from Project R for safety and communication purposes.

Initials:

C. Artificial Intelligence (AI) Tools

Project R uses AI tools ONLY for operational efficiency and staff support. AI is NOT used to make decisions about students, analyze individual student behavior, or interact directly with students or families. All AI suggestions are reviewed and approved by Project R staff. Humans make all final decisions.

I consent to Project R using AI tools for operational efficiency, understanding that AI is used only to support staff operations and not to make decisions about my child.

Initials:

D. Data Privacy and Security

Information collected includes: student name, school, grade, parent contact info, transportation schedule, GPS bus location during transport, attendance, and emergency contact information. All data is encrypted, access is role-based, and all handling complies with FERPA.

I understand how Project R collects, uses, and protects my family's information, and I consent to these data privacy and security practices.

Initials:

Questions? Contact Monica Smith at [email protected] or (815) 756-0483.

Signatures

By signing below, you are acknowledging that you have fully reviewed and understand the expectations and guidelines for Project R outlined in this document. Your signature confirms your agreement to adhere to the expectations and information provided.

Parent/Guardian Signature *

Student Signature *

Date