Please initial one of the two boxes below and sign and complete all information at bottom of form.
I hereby release BBBSOC/IE and its affiliates from all claims, demands or liabilities and related financial costs that I may now or hereafter have arising in connection with BBBSOC/IE ’s exercise of the right hereby granted. These include, without limitation, claims for compensation, claims for copyright or trademark infringement, infringement of moral rights, libel, defamation, invasion of any rights of privacy (including intrusion, false light, public disclosure of private facts, and misappropriation of name or likeness), violation of rights of publicity, physical or emotional injury or distress, or any similar claim or cause of action in tort, contract, or any other legal theory. BY INITIALING THIS OPTION AND SIGNING BELOW, I ACKNOWLEDGE THAT I HAVE READ AND I FULLY UNDERSTAND ALL OF THE TERMS OF THIS AGREEMENT AND THAT I AM VOLUNTARILY GIVING UP SUBSTANTIAL LEGAL RIGHTS.
It is important that staff maintain order and discipline in all programs. Top objectives in all BBBSOC/IE programs are safety and a positive atmosphere for learning and developing skills. The staff makes every effort to help children understand clear definitions of acceptable and unacceptable behavior. A child’s behavior is expected to be consistent with the following: Use appropriate language at all times, cooperate with staff and follow directions, respect other children and staff, equipment, facilities and yourself, maintain a positive attitude, keep hands, feet and other objects to self and stay in program areas.
Behaviors Resulting in Immediate Program Dismissal but are not limited to:
● Any action that could threaten or pose a direct threat to the physical/emotional safety of the child, other children or staff.
● Fighting or bullying
● Possession of a weapon of any kind
● Vandalism or destruction of school property, program property or property of others.
● Running Away
Parents/guardians are required to inform BBBSOC/IE in writing prior to a child’s acceptance in the program of any special circumstances which may affect the child’s ability to participate fully and within the guidelines of acceptable behavior, including, but not limited to any serious behavioral problems or special circumstances regarding psychological, medical or physical conditions.
1. I am the parent/guardian of the minor child specified below (“My Child”), who is participating in the Adult Site Based Program (the “Program”) offered by Big Brothers Big Sisters of Orange County/Inland Empire (“BBBSOC/IE”) as a volunteer mentee, or “Little”. I hereby consent and give My Child permission to communicate virtually and/or electronically with My Child’s Big or mentor, and other Littles or mentees participating in the Program. Such communication may include, without limitation, telephone, text message, email, and video conferencing programs such as Zoom, CommandLink, Google Classroom, and FaceTime. Such communication may also include social media platforms including, without limitation, Instagram, Facebook, Twitter, and TikTok, and online video game platforms including, without limitation, Xbox Live, Nintendo Switch Online, and PlayStation Plus.
I WILL COMMUNICATE WITH MY CHILD, WITH MY CHILD’S BIG OR MENTOR, AND WITH BBBSOC/IE TO DETERMINE WHICH COMMUNICATION METHODS AND PLATFORMS I APPROVE.
I further agree to supervise, monitor, and otherwise stay informed about My Child’s virtual and/or electronic communication with My Child’s Big or mentor, and to maintain an open dialogue with My Child concerning these virtual and electronic interactions.
I hereby expressly waive and release any and all claims which I may have, or which I may hereafter have, whether known or unknown, against BBBSOC/IE, and its officers, directors, staff, employees, volunteers, agents, affiliates, successors, and assigns, arising out of or attributable to My Child’s virtual and/or electronic communication with My Child’s Big or mentor, and other Littles or mentees participating in the Program.
BY INITIALING THIS OPTION AND SIGNING BELOW, I ACKNOWLEDGE THAT I HAVE READ AND I FULLY UNDERSTAND ALL OF THE TERMS OF THIS AGREEMENT AND THAT I AM VOLUNTARILY GIVING UP SUBSTANTIAL LEGAL RIGHTS.
“A GENERAL RELEASE DOES NOT EXTEND TO CLAIMS THAT THE CREDITOR OR RELEASING PARTY DOES NOT KNOW OR SUSPECT TO EXIST IN HIS OR HER FAVOR AT THE TIME OF EXECUTING THE RELEASE AND THAT, IF KNOWN BY HIM OR HER, WOULD HAVE MATERIALLY AFFECTED HIS OR HER SETTLEMENT WITH THE DEBTOR OR RELEASED PARTY.”
I shall defend, indemnify, and hold harmless BBBSOC/IE and all other Releasees against any and all losses, damages, liabilities, deficiencies, claims, actions, judgments, settlements, interest, awards, penalties, fines, costs, or expenses of whatever kind, including reasonable attorneys’ fees, fees and the costs of enforcing any right to indemnification under this agreement, and the cost of pursuing any insurance providers arising out of or resulting from any claim of a third party related to My Child’s participation in the Program, including any claims arising out of my own negligence, the negligence of My Child, or the ordinary negligence of BBBSOC/IE.
THIS AGREEMENT PROVIDES BBBSOC/IE WITH MY ABSOLUTE AND UNCONDITIONAL CONSENT, WAIVER, AND RELEASE OF LIABILITY ARISING OUT OF MY CHILD’S PARTICIPATION IN THE PROGRAM. BY SIGNING BELOW, I ACKNOWLEDGE THAT I HAVE READ AND I FULLY UNDERSTAND ALL OF THE TERMS OF THIS AGREEMENT AND THAT I AM VOLUNTARILY GIVING UP SUBSTANTIAL LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE BBBSOC/IE FOR ANY CLAIMS, WHETHER KNOWN OR UNKNOWN, ARISING OUT OF MY CHILD’S PARTICIPATION IN THE PROGRAM.