Prior to your in-person interview, please answer the questions below. The information you provide will also help us make a better match for you and assure we can support you during your involvement with our program.  Please note that you will have an opportunity to discuss these questions and your responses more thoroughly during your in-person interview.

In order for Big Brothers Big Sisters of Acadiana to provide a responsible and professional service to clients, it is necessary for volunteers, clients and parents/ guardians to be asked to divulge extensive personal information about themselves and their families. Big Brothers Big Sisters of Acadiana respects the confidentiality of client and volunteer records and, with the exception of the situations listed below, shares information about clients and volunteers only among the agency professional staff. 

 The right to confidentiality applies not only to written records, but also to video, film, pictures and use of client or volunteer names in agency publications. All records are considered the 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 organizations upon presentation of an authorized release of information form appropriately signed by the client or volunteer.
2. Identifying information regarding clients and volunteers may be used in agency publications or promotional materials unless the client or volunteer request otherwise.
3. For purposes of program evaluation, audit, or accreditation, and with the prior approval of the Board of Directors, Big Brothers Big Sisters of America may have access to client and volunteer records.
4. Members of the Board of Directors or evaluators appointed by the Board shall have access to client files upon authorization of the Board of Directors.
5. Information shall only be provided to the agency’s legal counsel in the event of litigation or potential litigation involving the agency.
6. Information shall only be provided to law enforcement officials or courts pursuant to a valid and enforceable subpoena.
7. It is required that any agency staff member who has a suspicion that a child is being abused or exploited must report this directly to the Department of Children and Family Services (DCFS) in the parish in which the suspected activity took place. If the misconduct of a current or former Volunteer Big, Board Member, Staff Person, or other adult associated with BBBS (other than the parent/guardian), is involved,  it is reported to Big Brothers Big Sisters of America. 
8. If an agency staff receives information indicating that a client or volunteer may be dangerous to himself or herself or to others, necessary steps may be taken to protect the appropriate party. This may include a medical referral or report to local law enforcement authorities.
9. At the time a child or volunteer is considered as a match candidate, information is shared between the prospective match parties. The information shared about the volunteer may include but not be limited to such items as: age, sex, race, religion, interests, hobbies, marriage, family status, sexual orientation, living situations, any prior felony conviction, etc. Information about the child may include but not be limited to such items as age, sex, race, religion, interests, hobbies, family situation, etc.

Purpose of This Form: Big Brothers Big Sisters of Acadiana (BBBS of Acadiana) and Big Brothers Big Sisters of America (BBBSA) want to use images, videos, and information about you or your child (referred to as "the Minor Child") for various materials. This form explains how this information will be used and seeks your consent.

What We Are Requesting: By signing this form, you give BBBS of Acadiana, BBBSA, and their partners permission to use:

• Photos, videos, and audio recordings of you or the Minor Child
• Quotes, writings, and other personal information
• Any other related materials (collectively referred to as "Released Materials")

How We Will Use the Materials: The Released Materials may be used in:

• Internal and external publications
• Marketing and recruitment materials
• Fundraising campaigns
• Advertisements and Public Service Announcements
• Online and social media platforms
• Any other media now existing or created in the future

These materials will be used to promote BBBS of Acadiana and BBBSA’s programs and initiatives.

Your Rights and Understanding:

• You give BBBS of Acadiana and BBBSA the right to use the Released Materials in any form, either alone or combined with other content.
• You understand that all materials created using the Released Materials are owned by BBBS of Acadiana and BBBSA.
• BBBS of Acadiana and BBBSA can allow other organizations to use these materials.
• You transfer all rights, including copyrights, of the Released Materials to BBBS of Acadiana and BBBSA.
• You acknowledge that you will not review or approve the materials before they are used.
• BBBS of Acadiana and BBBSA are not obligated to use the Released Materials.

Release from Liability: You release BBBS of Acadiana, BBBSA, their employees, agents, and partners  from any claims or liabilities related to the use of the Released Materials. This includes claims for compensation, defamation, invasion of privacy, or any other personal or property rights violations.

Agreement: By signing below, you acknowledge that you have read and understood this consent form and agree to its terms.

I understand that and consent to the following:

1. The references and youth serving-organization I listed may be contacted by mail, telephone, email, or in-person;
2. The information I provided may be used to conduct a background check, to include a search of public domain records, driving records check, juvenile and adult criminal history check (see attached authorization), military records, and other records where required by local, state, or federal law for volunteers working with youth;
3.  I am in no way obligated to perform any volunteer services;
4. The BBBS agency is not obligated to match me with a youth and may deny my application or close my match at any time, and to protect all participants’ confidentiality, BBBS is not required to disclose reasons for doing so.
5. Other BBBS agencies and youth organizations where I have worked or volunteered may be contacted as references.
6. As part of the enrollment processes, I will be required to provide additional personal information, including completion of an in-person interview.
7.  I understand that the information I provide in the enrollment process will be kept confidential, unless disclosure is required by law.
8.  I understand that detailed accounts of child abuse or neglect, past or present, will be reported to proper authorities;
9. I understand that certain relevant information about me will be discussed with the parent/guardian of a child who is a prospective match (this might include demographic information, information relevant to parent/child preferences, and any information relevant to a child’s safety or well-being).
10. It is my responsibility to update the agency if any of the information I provide on this application, in my interview, or any other information provided during the enrollment process changes (i.e. address, phone number, auto-insurance, new criminal charges, etc.).
11. I agree to complete questionnaires throughout my time in the program to evaluate and improve program services;
12. I agree to timely communication and follow-up with all agency staff as required by the agency.