Guardian Consent Form

This form is required of all students under the age of 18, and must be submitted prior to a student's first session. If this form has not been submitted and approved prior a student's first session, that session will be cancelled.

I hereby consent for my child’s participation in online and distance learning activities as part of the STEMPod Tutoring and Mentorship programs. I consent to:

STEMPod will use, but not disclose personal information about my child that is collected through online enrichment programming offered by the Tutoring and Mentorship programs. I understand that this is to facilitate virtual classes/meetings between STEMPod faculty/staff and student(s).

This consent form covers all forms of distance learning, included but not limited to video courses, web-based courses, and phone calls. Your child’s image and audio may be transmitted during portions of distance learning. 

STEMPod will be using Zoom video conferencing software to facilitate live “class” meetings. STEMPod is not the Operator of Zoom’s services. You may review their privacy and security policies by using the following: and STEMPod will not be maintaining online records (recordings) of student online activities. 

At any point you may review the personal information collected from your child and you may also opt out of this programming and revoke your consent. If you desire to submit a request or to revoke this consent, please write down your request or revocation of consent and email it to

Thanks for submitting!