Men In Training Mentor Program

An estimated 8.5 million youth (about 20%) do not have caring adults in their lives, putting them at serious risk. Men In Training aims to partner caring adults with hurting children in an effort to prevent academic failure, criminal activity, drug abuse and other serious risk behaviors. Research finds that resilient youth-those who successfully transition from risk-filled backgrounds to the adult world of work and good citizenship-are consistency distinguished by the presence of a caring adult in their lives.

Apply to be a Mentor

Sign Your Child Up For M.I.T.!

MIT Applicant

Parent's Name(s)

Child's Name

Email Address

Parent Phone #

By submitting this form, I am giving my child permission to be in the Men in Training Mentor Program and agree to support his relationship with his Mentor. I also give my child permission to participate in all mentor program activities. I give my child permission to be transported by MIT and its volunteers. I agree to not hold Men in Training or its volunteers liable for any illness, injury or accident, which may occur on these outings or anywhere lese. I hereby authorize the MIT staff/volunteer to obtain appropriate emergency medical attention for the above-named child should attention be required while I am unavailable for contact at the telephone number(s) listed. By submitting this form, I also give my permission for my child's picture to be used for the purpose of program recruitment and public relations. By submitting this form, I am giving my child permission to be in the Men in Training Mentor Program and agree to support his relationship with his Mentor. I also give my child permission to participate in all mentor program activities. I give my child permission to be transported by MIT and its volunteers. I agree to not hold Men in Training or its volunteers liable for any illness, injury or accident, which may occur on these outings or anywhere lese. I hereby authorize the MIT staff/volunteer to obtain appropriate emergency medical attention for the above-named child should attention be required while I am unavailable for contact at the telephone number(s) listed. By submitting this form, I also give my permission for my child's picture to be used for the purpose of program recruitment and public relations. I have read and agree

MEDICAL NOTE: Please note any allergies, physical challenges or special medications

School Name

Grade

Child's Birthdate (MM/DD/YYYY)

Address (street number, city, state, zip)