LOS ANGELES COUNTY PROBATION DEPARTMENT



LOS ANGELES COUNTY PROBATION DEPARTMENT

JJCPA PROGRAMMING

PARENTAL AGREEMENT

Dear Parent:

Deputy Probation Officers (DPOs) will be offering prevention services to children under the provisions of the JJCPA program. These DPOs will be housed at selected school sites and other program locations throughout Los Angeles County. We are engaged in programming designed to provide direct and indirect services such as counseling or involvement in positive activities for youth and families who desire additional exposure to proactive events. We work with schools, counseling organizations, and other service agencies in the community; we are seeking your permission to team with you in order to interact with your child on an on-going basis to develop a plan that centers around your child’s, family and community strengths.

PLEASE BE AWARE THAT YOU OR YOUR CHILD CAN WITHDRAW FROM THIS PROGRAM AT ANY TIME.

THERE ARE NO FEES FOR THIS SERVICE.

In consideration of the student, _______________________________, participating in this voluntary program, the minor and parent(s) release the County of Los Angeles and the Los Angeles County Probation Department, of all liabilities that might occur as a result of participation in this program.

Note: Even though your child’s name will remain anonymous, information regarding behavior, academic performance, and school attendance will be kept for statistical purposes by the Probation Department in order to study the effectiveness of this program.

Limited information may also be shared with the agency that submitted the 236 WIC Service Referral form.

If you would like your child involved in our services, sign and date this letter and return it to our office.

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|(Parent Signature) | |(Date) |

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|(Minor’s Signature) | |(Date) |

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|(DPO’s Signature) | |(Date) |

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