ABOUT THE 1:1 MENTORING

Elevated Up CIC provides bespoke 1:1 mentoring sessions tailored to the individual needs of each child. Sessions may focus on confidence building, emotional regulation, behaviour support, social skills, self-esteem, goal setting, resilience and confidence where appropriate. Mentoring is supportive and developmental and does not replace therapy or clinical services

YOUR DATA

Your data will be handled and processed in accordance with the General Data Protection

Regulation 2018 (GDPR) and the Data Protection Act 2018. All data will be treated

confidentially until it is fully anonymised. If consent has been given to recording of your participation, all recordings will be destroyed once analysed. All electronic data will be stored on Elevated Up CIC password protected, secure cloud Consent to participate will be kept separately to the data. The anonymised data may be used in the production of research reports. Please only consent to participation if you are happy with this.

Mentee's First name

Mentee's Last name

Mentee's Birthday

Day

Month

Year

Address

Parent/ Guardian Full name

Relationship to Mentee

Phone

Does your child have any Medical conditions, allergies, SEND needs or diagnosis we should be aware of?

Photography/Media consent

I agree for sessions to be recorded

I do not agree for sessions to be recorded

In the event of an emergency. I give permission for appropriate medical treatment to be sort if I cannot be contacted.

Yes

Date

Day

Month

Year

Parent Guardian Declaration I confirm that the above information provided is accurate and I give consent for my child to participate in 1:1 mentoring sessions with Elevated Up CIC.

Pay for your session

£25

Signature

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Elevated Mentoring
Consent and Agreement Form

Elevated Mentoring Consent and Agreement Form

Elevated Mentoring
Consent and Agreement Form