Students

Parent/Guardian Consent

Required before a student can create an Assistly account. A parent or guardian completes this together with the student.

Student Information

Student full name

Required

School

Grade

Parent/Guardian Information

Full name

Required

Relationship to student

Home address

Primary phone

Email address

Enter a valid email

Primary Emergency Contact

If different from parent/guardian above.

Name

Relationship

Phone

Secondary Emergency Contact (optional)

Name

Relationship

Phone

Medical Information (optional but recommended)

Consent

My child's participation is completely voluntary, Assistly is a referral platform only (not an employer, supervisor, or payment processor), and I am responsible for determining whether individual opportunities are appropriate for my child. I authorize Assistly to communicate with my student and with me regarding participation and available opportunities. I give permission for my child to participate in Assistly. I authorize Assistly to use photographs, videos, or testimonials of my child for educational, promotional, or program reporting purposes. (Optional — leave unchecked to decline.)

Transportation

My child will provide their own transportation I will provide transportation Transportation will be arranged separately with the requesting family

In a medical emergency, if I cannot be reached, I authorize emergency medical personnel to provide treatment reasonably necessary to protect my child's health and safety. I understand I remain financially responsible for any care provided.

Signatures

Parent/guardian — type full name as signature

Required

Student — type full name as signature

By signing, the student confirms they understand participation is voluntary, they may decline any task, and they will communicate respectfully and report safety concerns immediately.

By submitting, you agree to Assistly's Terms, Privacy Policy, and Community Standards.

Submitted for review

Thanks! We've received the consent form. Our team will review it, and you'll get an email once your student is approved to create their account in the Assistly app.