Non-Discrimination Policy
All BBBS participants, including youth, families, volunteers, board and staff serving as volunteer Bigs are not excluded on the basis of race, ethnicity, religion, national origin, color, gender, marital status, sexual orientation, gender identity, gender expression, citizenship status, veteran status, or disability. 


All information on this application is confidential.  We use this information to assist in matching your child and for grant funding only.
Child Information

e.g. Jr, III

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

Press CTRL while choosing to select multiple

*To find your child's expected HS Graduation Year by grade Click Here

Enter numbers only starting with area code

e.g. father, mother, step-father, aunt etc

e.g. father, mother, step-father, aunt etc

Guardian Information
Input format: mm/dd/yyyy
Enter numbers only starting with area code
Enter numbers only starting with area code
Enter numbers only starting with area code
Type NA if unemployed

Family Information

Physical Address

Existing Household Members
Please choose this child's relationship to the following people:

Emergency Contact
In the event you cannot be reached please provide an emergency contact:

The following information will help assist us in matching your child to a screened Big (volunteer).

Check all that apply

Check all that apply

Check all that apply

Check all that apply

Hidden Fields
For notifications

Media Release
Confidentiality Policy & Permission Form
Confidentiality & Obligation Release - Parents and Guardians

The Big Brothers Big Sisters agency respects the confidentiality of youth and parent records and shares this information only among agency professional staff, except where legally required.  State law mandates that suspected child abuse be reported to the appropriate authorities.  

I understand that:
  • Any information that reveals my or my child’s identity will be held confidential.
  • For purposes of program evaluation, audit, or accreditation, certain bodies such as BBBS of America or National Student Clearinghouse (NSC) may have access to my child’s records. NSC will produce aggregate reports to BBBS on the number of students who move on to post-secondary education. I will inform BBBS if I choose to opt-out.
  • Any school, clinical, or medical records of any kind will be held confidential.
  • Information will be released to other individuals and organizations only upon presentation of an authorized “consent to release information” form signed by me.
  • All records are considered property of the agency.
  • Information about potential volunteers that may be shared with the youth and guardian will include the volunteer’s age, gender, race/ethnicity, religious affiliation, interests and hobbies, contact information, family and living situation, experience with children, medical/mental health status, sexual orientation, criminal background, substance use, reason for involvement, input from collateral contacts(references, mental health professionals, agency staff), and an overall summary of why the volunteer was chosen for the match.
  • Information about the potential Little Brother or Little Sister that may be shared with the volunteer will include the same categories as volunteers, along with a summary of needs, expectations for match participation, and anticipated challenges the volunteer may encounter.
  • I will NOT discuss additional information that I may encounter about the volunteer without permission of agency staff.
  • Agency staff will hold my child’s disclosures related to the child’s gender identity and/or sexual orientation confidential if my child does not want that information shared with me. Agency staff will encourage my child to find a safe and supported way to share this information with me when the child is ready to do so. 

Obligation Release & Permission to Participate

I give permission for my child to participate in the Big Brothers Big Sisters program. 

I understand that:
  • The agency is not obligated to match my child with a volunteer.
  • I am in no way obligated to participate in this program, nor is my child.
  • To protect the confidentiality of clinical and school reports, the agency will notify the parent of non-acceptance by letter, but it is not obligated to disclose the reason for non-acceptance.
  • Parents and guardians must sign this statement in order to participate in the program.
  • My child and I must participate in an enrollment process which includes an orientation, interview, and review of safety information
  • No fees are charged for requesting a Big Brother/Big Sister.
  • As a Parent/Guardian, you may now receive emails and/or text messages inviting you and your family to agency activities and events.