Big Brothers Big Sisters of Big Sky Country

Non-Discrimination Policy

Our participants come to us with a wide range of personal characteristics. We believe that participant eligibility shall be determined without regard to race, color, religion, national origin, gender, marital status, sexual orientation, gender identity, veteran status, or disability.

BBBS of Big Sky Country Elementary School Little Application

Hidden Fields

BBBS Contact Person Email

Youth Contact Owner ID

To look up the owner's email for notifications

Youth Contact Owner Email

For notifications

Youth Contact ID

Youth Enrollment ID

Additional Youth Found

YesNo

Youth Information

First Name

Middle Name

Last Name

Preferred Name

Birthdate

Enter a date in the following format: mm/dd/yyyy

Gender	Personal Pronouns
How does the youth identify?	What pronouns does the youth use?
School	Graduation Year This is the year the youth will graduate.
Which community are you in?	Grade This is the year the youth will graduate.
Does your child attend LINKS after school program (Livingston School District)? YesNo	Race/Ethnicity Press CTRL while choosing to select multiple
Tribal Affiliation

Does the youth have their own phone?

YesNo

Youth's Phone

Does the youth have their own email?

YesNo

Youth's email

Guardian Information

Guardian Contact ID

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Gender/Gender Identity

Parent/Guardian Personal Pronouns

Mobile Phone

Home Phone

Work Phone

Work Phone Ext

Preferred Phone

Best Time to Call

Personal Email

Work Email

Alternate Email

Preferred Email

Contact Preference

Employer

Type NA if unemployed

Guardian's Relationship to Youth

Do you have legal custody of this youth?

YesNo

Is there a person who shares custody of this youth?

YesNo

Custody is shared with:

Family Information

Youth Living Situation

Living Situation Description

Mailing Street Address

Mailing City

Mailing State

Mailing Zip Code

Mailing County

Please check here if your mailing address is different from your residential address:

Residential Address

Street Address

City

State

Zip Code

Emergency Contact

Emergency Contact First Name

Emergency Contact Last Name

Emergency Contact Phone

Emergency Contact Relationship to Youth

Parent/Guardian Agreements

By checking the box below, I give permission:

For my child to participate in the Big Brothers Big Sisters Program;
For the volunteer matched with my child, who has been screened and approved by Big Brothers Big Sisters, to spend time with my child during the school day once a week;
To have my child participate in an intake interview conducted by Big Brothers Big Sisters staff, and complete questionnaires through their time in the program containing questions about school, home life, and personal interests;
To have my child talk with a Big Brothers Big Sisters staff person about personal safety.

I accept the terms and conditions

Little Ground Rules

Please go over the following rules with your child:

The Little will be respectful to their Big
The Little will not share any personal contact info with their Big
The Little will talk to the BBBS staff if there's anything they are unsure of or have questions about
The Little will not communicate with their Big on any form of social media

I have gone over these rules with my child and he/she agrees to abide by them.

Media Consent

I give permission for me and/or my child to be depicted in the Big Brothers Big Sisters program through various avenues of media, such as photographs, quotes, video depiction, drawings, or otherwise, for any purpose which the organization deems fit without compensation to me or my child. I understand it is not guaranteed that my child or I will be featured in any or all such media coverage.

Yes - Opt InNo - Opt Out

Confidentiality Policy

In order for Big Brothers Big Sisters of Big Sky Country to provide responsible, professional service to clients, it is necessary for volunteers, clients and parents or guardians of clients to divulge extensive personal information about themselves and their families. The agency respects the confidentiality of client and volunteer records. Such personal information about clients and volunteers shall be shared only among the agency professional staff.

I have read and understand the above information provided to me regarding Big Brothers Big Sisters' confidentiality policy. I agree to the conditions set forth.

Participant Release Form

I release Big Brothers Big Sisters of Big Sky Country from any and all liability in connection with injury caused by participating in the Big Brothers Big Sisters program.

I, likewise, hold harmless from liability any person transporting my child to or from any Big Brothers Big Sisters activity. I am also certain that my child is in good health and able to participate in the program activities.

By checking the box below, I hereby give permission for my child to participate in the Big Brothers Big Sisters Program. I understand that I will be contacted by BBBS staff for regular (bi-monthly or quarterly) check in meetings. I also commit to having my child matched with his/her Big for a minimum of one school year, barring extenuating circumstances. I give permission for BBBS staff in charge of my child, to obtain all necessary medical care for my child, and I hereby authorize any licensed physician and/or medical personnel to render necessary medical treatments to my child.

I accept the terms and conditions.