ChesterParkElementary School

Center of Literacy through Technology

835 Lancaster Hwy.

Chester, SC29706

(803) 581-7277

Please read and fillout the form below if you would like to provide your child with the opportunity to participated in group counseling

PERMISSION FORM FOR GROUP COUNSELING

Dear Parent:Date______

Mr. Morrissey, the school guidance counselor at Chester Park COLT, would like to offer your child the chance to participate in group counseling. Each year the school counselor conducts groups to aid children in meeting a range of personal and/oracademic challenges.Your child’s group will focus on:

______

Personal information discussed in groups by students will be kept confidential by the counselor and will only be disclosed when and if a child’s safety is at risk. Student participants are also expected to maintain the privacy of their fellow group members. However, group member’s commitment to maintaining confidentially can notbe guaranteed due to their age and maturity.

If you have any questions concerning groups, please call (803) 581-7275 and ask to speak with the school guidance counselor, Luke Morrissey. This permission form below must be signed and returned to Mr. Morrisseyor your student’s teacher, before your child may join a group.

Thank you for taking the time to consider this request to serve your child.

Sincerely,

______
COLTSchool Counselor

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I, ______(parent/guardian) give permission

for my child, ______, to participate in group counseling during the school day at Chester Park COLT Elementary. I understand that this counseling will be provided by Luke Morrissey the school guidance counselor at COLT.

Signature of (parent/guardian)______Date ______

COLT Mission Statement

We promote academicachievement through highexpectations in a safe andwelcoming environment. Supported by the community, we provide anexciting and challengingtechnology integrated curriculum that preparesour students for the future