Little Onboarding Packet

Youth Full Name*
Parent/Guardian's full name*
Email*

Confidentiality Policy

Big Brothers Big Sisters 7 Rivers Region (BBBS7) respects the confidentiality of youth and their families as well as volunteer records and, with exception of situations listed below, shares information about youth and their families and volunteers only among agency professional staff. All records are considered property of the agency and not the agency workers or clients or volunteers themselves. Records are not available for review by the clients or volunteers.

 1 - Information will be released to other individuals or non-BBBS organizations only with the client or volunteer’s written consent.

 2 - For the purposes of program evaluation, audit, or accreditation, and with the prior approval of the Board of Directors, certain outside bodies such as Big Brothers Big Sisters of America may have access to client and volunteer records.

 3 - For the purposes of program evaluation, members of the Board of Directors or evaluators appointed by the Board have access to client files upon authorization of the Board of Directors.

 4 - Any person granted access to agency child or volunteer files will sign a confidentiality agreement.

 5 - Information shall only be provided to law enforcement officials or the courts pursuant to a valid and enforceable subpoena.

 6 - Information shall be provided to an agency’s legal counsel in the event of litigation or potential litigation involving the agency.

 7 - State law requires professionals who work with children and their families to make a child protection report if they know or have reason to believe a child is being neglected or abused or has been neglected or abused within the preceding years.
 *** In Minnesota, our volunteers, as our delegates, are also mandated reporters and are required to report suspected child abuse to the appropriate authorities. In Minnesota reports can be made by calling the appropriate county human services offices.

 8 - If an agency worker receives information indicating that a client or volunteer may be dangerous to himself or herself or others, necessary steps may be taken to protect the appropriate party. This may include a medical referral or report to the local law enforcement authorities.

 9 - At the time a child or volunteer is considered as a match candidate, anonymous assessment information is shared between the prospective match parties. The information about the volunteer may include, but is not limited to, such items as: age, sex, race, religion, interests, hobbies, marital status, family status, sexual orientation and living situation. Information about the child may include, but is not limited to, such items as: age, sex, race, religion, interests, hobbies, and family background. Any party has the right to refuse to enter into the match based on the information so communicated.

Confidentiality Policy Affirmation*
It is important that you as a volunteer fully understand agency rules and policies. A violation of a rule or policy may endanger your right to coverage by the agency’s policy or may result in the closure of your match.

Caregiver Responsibilities - Safety

I understand BBBS staff and Bigs are mandated reporters. This means BBBS and Bigs are required by law to report any reasonable suspicions/signs of child abuse or neglect.
I understand that BBBS follows state laws and recommendations that children ages 4-7 MUST sit in the backseat in a booster seat, and children ages 8-12 should sit in the backseat. Seat belts are required AT ALL times for both Bigs and Littles.
I understand an adult (someone 18 or older) must be at home when my child is picked up and dropped off by his/her Big. I will ensure an adult is always there for pick-up and drop-off. I understand my child will be supervised by his/her Big at all times during their outings.

Emergency Contact Information

Emergency Information provided to Big
The following information will be provided to the Big as an authorization to consent to such medical and/or surgical treatment as deemed reasonably necessary for your child in the event of an emergency illness or accident. If practicable under the circumstances, these medical services are to be performed by:
Physician*
Emergency Contact Name*
Emergency Situation Affirmation*
This is an authorization for the Big Brother/Big Sister to consent to such medical and/or surgical treatment as deemed reasonably necessary for my child in the event of an emergency illness or accident.
MM slash DD slash YYYY

Caregiver Responsibilities - Match Support

I understand keeping in touch with my Match Specialist (MSS) is a REQUIREMENT of the program. Match support is a service provided by BBBS to help support my child’s match and monitor my child’s safety in the match.
I understand BBBS requires me to be in contact with my MS every 30 days. I will be prepared to discuss the outings in which my child participates, how the relationship is developing with my child’s Big and how often they meet. I will return contact attempts made by my MSS.
I understand that if I have concerns or a problem arises in my child’s match relationship it is my responsibility to contact my MSS immediately.
I understand a lack of communication, or unreturned communications, with my MSS could result in my child’s match being closed if we are not in compliance with BBBS standards.
I will work with my child, my child’s Big and my MSS to set goals to enhance my child’s development. Goals may include education, personal growth and social behavior etc.
I understand I must contact my child’s Big and my MSS promptly regarding any changes in my address, email or phone number.

Caregiver Responsibilities - Friendship

I understand my child and his/her Big are expected to spend time together three to four times per month for a minimum of 18 consecutive months. I understand BBBS encourages long-lasting relationships, and matches can remain open until my child turns 18 or graduates high school.
I understand the focus of the BBBS program in one-on-one time between my child and his/her Big. I will not ask my child’s Big to bring along other children (friends or siblings) on their outings.
I understand communication with BBBS and my child’s Big is key to the success of their match. I will maintain weekly communication with my child’s Big and monthly communication with BBBS.
I understand that consistent contact between my child and his/her Big is in my child’s best interest. Therefore, I will not take away my child’s outings with his/her Big as punishment. If my child needs to be disciplined, I will speak with my child’s Big about the situation and work together to determine an appropriate outing/activity that takes into account my child’s misbehavior.

Caregiver Responsibilities - Boundaries

I understand my child’s Big will choose safe and age-appropriate activities with my child. I understand that I have the right to say no to any activity. I also understand that I should be informed of the activity the match will engage in before they go on their outing.
I understand BBBS encourages my child’s Big to plan inexpensive or no-cost outings. I will provide money for outings if I am able so that the Big does not have to spend much money. I will not ask my child’s Big to provide expensive activities or buy things for my child.

Little Responsibilities

Check to acknowledge and accept:*
By signing below, I indicate that I discussed the agency rules and policies with the Match Specialist, and I understand and agree to my responsibilities as discussed.*
*

Firearm Policy

Firearm Policy Affirmation*
A volunteer who owns firearms and stores them at his/her residence or any other location will lock the weapons or install trigger locks whenever a Little is at or near the storage area. Ammunition will be stored separately from the weapons and inaccessible to the Little. Firearms or accessories will never be accessed or used during any activities with a Little. By signing this Firearm Policy I agree to abide by all Firearm guidelines set forth by the Big Brothers Big Sisters 7 Rivers Region Agency.

Media Consent and Release

I understand and agree that all materials created by BBBS7 that use the Released Materials are the property of and are owned by BBBS7, and that I cannot authorize their use by any other party.

I acknowledge and agree that I have no right to review or approve the Released Materials before they are used by BBBS7, and that BBBS7 has no liability to me for any editing or alteration of the Released Materials or for any distortion or other effects resulting from BBBS7’s editing, alteration or use of the Released Materials.

I hereby release BBBS7, employees, and agents from all claims, demands or liabilities and related financial costs that I or the Minor Child may now or hereafter have arising in connection with BBBS7’s exercise of the rights hereby granted, and/or with the appearance of the Released Materials in any publication or production. These include, without limitation, claims for compensation, defamation, or invasion of privacy, or other infringements or violations of personal or property rights of any sort whatsoever.
Media Consent and Release Preference*

Consent to Participate

By signing below, I give permission:

 1 - For my child to participate in the Big Brothers Big Sisters Program;

 2 - For the volunteer matched with my child, who has been screened and approved by Big Brothers Big Sisters, to transport my child to events and match activities;

 3 - For the school to provide social and academic information about my child to Big Brothers Big Sisters (e.g. report cards, behavior reports);

 4 - To have my child participate in an in-take interview conducted by Big Brothers Big Sisters staff and complete questionnaires throughout his/her time in the program containing questions about school, home life, and personal interests;

 5 - To have my child talk with Big Brothers Big Sisters staff about personal safety;

 6 - For me and my child to be contacted by BBBS staff frequently (monthly for the first year and then quarterly) throughout the match to talk about the match relationship;

 7 - For Big Brothers Big Sisters staff to provide contact information for me and my child to the volunteer.

I understand that the program is not obligated to match my child with a volunteer and that as part of the enrollment process I will be asked to provide additional information through an in-person interview. I understand that the information I provide in the enrollment process will be kept confidential, unless disclosure is required by law and with exceptions noted. I understand that incidents of child abuse or neglect, past or present, must be reported to proper authorities. I understand that certain relevant information about my child will be discussed with the volunteer who is a prospective match (i.e. demographic information, information relevant to volunteer preferences, and information relevant to child-safety and well-being).

I certify that all of the information on this form is true and correct and that all income is reported. I understand this information is being given for the receipt of federal funds, that the information on this application may be verified, and that deliberate misrepresentation of the information may subject me to prosecution under applicable state and federal laws. I understand this information will not affect my qualification for the program,

I do hereby release the organization and its employees, agents, members, volunteers and all other persons on its behalf from any and all liability for any damage or injury which such child might sustain while participating in said program and activities, including but not limited to any liability to any right of action that may occur to such child directly, or to me as his/her guardian. I understand that this information may be shared with the school or with partnership agencies when applicable. If my child is matched with a Big Brother or Big Sister I agree to support my child's match by reviewing the program and safety information given to me by Big Brothers Big Sisters, communicating with Big Brothers Big Sisters staff as outlined in expectations (which includes communication at least once a month in the first year of the match), and immediately reporting any concerns I might have to Big Brothers Big Sisters staff.
Consent to Participate Affirmation*
Little's Name