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Grade ( Circle one )



STREAM – twice-weekly after school courses are taught at Center City Congress Heights, Garfield
Elementary, and Hart Middle School. Topics include Robotics, Graphic Design, Renewable Energy,Videography, and much more.

Mentoring – group session are held two Saturdays a month and include field trips.

Summer of STREAM – six-week summer camp offering STREAM courses and recreation.


Please list all known allergies (to include food allergies, medicine allergies, bee stings, etc.) and describe the reaction and management of the reaction.


* Please check only 1 box *

Annual household income


*Please read and initial each section*

Medical Attention: I, parent/guardian of the Scholar named herein, do hereby give my permission to the medical personnel selected by College Tribe to order treatment and necessary transportation for my child. In the event I cannot be reached in an emergency, I hereby give my permission to the physician to secure and administer treatment, including authorization for my child named above.

Media Release: I also do hereby give permission to College Tribe to use photographic, video, or digital images in which my son appears in publications used for the purposes of education, information, promotion, public relations, and fund-raising for College Tribe.

Education Release: I also do hereby give permission to my son’s school to copy and release his report card to College Tribe for informational purposes only. I understand that this authorization remains in effect for the 2022-2023 school year.

Transportation Release: I give permission for my son to be transported to College Tribe mentoring located on 3845 South Capitol Street SW. I understand that my child is expected to follow all applicable laws regarding riding in a motor vehicle and is expected to follow the directions provided by the driver and staff bus monitor. Only registered students with a permission slip are allowed to ride the bus. Transportation will only take students to the church and back to their school; the bus cannot take students to their homes.

Thanks for submitting!

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