Fellowship Parent and Student Agreement

Teen Fellow Name and Pronouns *

Parent or Guardian Name and Pronouns *

Additional Parent or Guardian Name and Pronouns

Mailing Address

Address Line 1

Address Line 2

City

State

Zip Code

Teen Fellow phone # (If guardians allow contact by muse staff via phone- this is considered permission)

Parent or Guardian Phone #

Additional Parent or Guardian Phone #

Student Birthdate *

Do you require any accommodations to fully participate in the Teen Fellowship? Please let us know your needs below, and we will meet your needs to the best of our ability.

Checkboxes *

FELLOWSHIP COMMITMENT. I have read the fellowship packet and agree to participate in the fellowship and abide by the following requirements: Attend all fellowship classes, complete 4 mentorship sessions with a mentor provided by The Muse, and participate in public readings at The Muse (four absences are allowed) agree to attend the fellowship conference and agree to complete all feedback surveys.
CONDUCT & DRESS CODE FOR STUDENTS Conduct: Profanity is not allowed during the Teen Fellowship, Teen classes, or Teen events. Freedom of expression is encouraged with appropriate language in your personal presentation and creative works. Use your best judgement when conducting yourself, keeping in mind mutual respect, punctuality, and an open mind. The Muse and its programs do not discriminate based on gender, race, religion, ethnicity, sexual orientation, or socio-economic status. We expect our students to demonstrate this basic respect as well. Dress Code: Students and teachers are expected to wear appropriate clothing to class, camps, readings, and events. “Appropriate” clothing falls into the category of the dress codes of public schools. We encourage free expression, but with professionalism & tact for a focused learning environment.
WAIVER OR LIABILITY and HOLD HARMLESS I agree as one of the conditions of my participation in the Teen Writers Fellowship or any other events associated with The Muse, to specifically release The Muse Writers Center, its students, teachers, and employees from any claims or liabilities of any kind whatsoever, arising from or related to my participation in classes & events. If I accept transportation assistance facilitated by The Muse Writers Center (such as an Uber, Lyft, or Taxi service), I agree the same terms apply during transit to and from The Muse Writers Center.
MEDIA RELEASE I agree to grant to The Muse Writers Center and its authorized representatives permission to record photos of my participation and audio or video footage of my experience of The Muse classes, programs, and events. I further agree that any of the material photographed or recorded may be used in any form, as part of the nonprofit's future publications, social media content, or printed materials. I agree that such use shall be without payment of fees, royalties, special credit or other compensation.

Student Signature *

Clear Signature

I have read the above guidelines and packet and agree

Parent Signature *

Clear Signature

I have read the above guidelines and packet and agree

Date of Signature *