Parent/Guardian
Agreement
I
understand that the program is not obligated to match my child and that I may
be asked to provide additional information through an in-person interview,
which will be kept confidential unless required by law.
I
acknowledge that incidents of child abuse or neglect will be reported to the
proper authorities. Relevant information about my child will be discussed with
the prospective match, including demographic information, preferences, and
child safety and well-being. I certify that all the information in this form is
true and correct.
I
acknowledge that this information may be verified for the receipt of federal
funds, and deliberate misrepresentation may result in prosecution under
applicable state and federal laws. This information will not affect my
qualification for the program.
On
behalf of myself and my child, I completely release and forever discharge Big
Brothers Big Sisters of Central Mass/MetroWest and its employees, agents,
volunteers, and all others involved from any claims, liabilities, obligations,
damages, actions, causes of action, suits, demands, costs, losses, debts,
penalties, fees, and attorneys' fees arising from participation in the program
and activities.
This
release and discharge are intended to provide the broadest release possible
permitted by law and may be shared with the school or partnership agencies when
applicable. If my child is matched with a Big, I agree to support the match by
reviewing program and safety information, communicating with Big Brothers Big
Sisters staff as outlined in expectations, and promptly reporting any concerns
to Big Brothers Big Sisters staff.