1. The references and youth-serving organization(s) 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

• Volunteers must disclose the ownership of any firearms and weapons to BBBS staff prior to being matched and throughout the match relationship. 
• Weapons, firearms, and ammunition owned by the volunteer must be licensed, permitted, registered, and handled in accordance with all state and federal laws. 
• BBBS staff will disclose the ownership of any firearms and weapons to the parent/guardian. 
• Weapons, firearms, and ammunition must be inaccessible to children unless participating in an activity approved by the parent/guardian, volunteer, and BBBS staff (ex. - hunter safety class). 

I hereby accept the invitation of Big Brothers Big Sisters of South Central Indiana (BBBSSCI) to appear and be identified in print in any BBBSSCI publication or production.

I hereby grant to BBBSSCI and its affiliates the right to use this image, name and biographical information as they may desire, in all media and in all forms, including but not limited to, publications, any televised photography and recordings.

In consideration of $0 to me paid, I hereby grant to BBBSSCI the absolute right to use this image made through BBBSSCI studios or elsewhere, in whole or in part, in true or distorted character of form, alone or in conjunction with any other images, name or reproduction, in color or otherwise, for art, advertising, business, trade, or any other lawful purpose whatsoever, in perpetuum.

I hereby release BBBSSCI and its affiliates from all claims, demands or liabilities and related financial costs that I may now or hereafter have arising in connection with BBBSSCI’s exercise of the right hereby granted, with my appearance in any publication or production. These include, without limitation, claims for compensation, defamation, or invasion of privacy, or other infringements or violations of personal or property rights of any sort.

Drug and Alcohol Use

• Volunteers will not possess or use illegal drugs.

• Volunteers will not consume alcohol prior to and during an outing with a child.

Overnight Visits

• Overnight trips and visits for volunteers and children are not allowed under any circumstances.

Transportation

• Only volunteers in the Community and Site-Based Plus program are allowed to transport children in a motor vehicle.

• Volunteers and children must wear safety belts.

• Children younger than eight years must be properly secured in a car or booster seat.

• Volunteers must operate their motor vehicle in accordance with all other Indiana State Laws.

• The explosive power of air bags has killed children and elderly adults less than five feet tall. If a car is equipped with an air bag on the passenger side, the National Safety Council recommends putting children younger than 12 years in the back seat.

Volunteers, children, and parents/guardians are required to abide by the following policies and procedures. Violations of these policies and procedures may result in immediate match closure.

Child Abuse and Exploitation

• Volunteers will not use any form of emotional, physical (including spanking) or verbal abuse to discipline a child.
• Incidents or allegations of child abuse or exploitation must be reported to the police or the Department of Child Services in accordance with state law by calling the Indiana Child Abuse and Neglect Hotline 1-800-800-5566.

Child Visiting Volunteer’s Home

• Only volunteers in the Community and Site-Based Plus programs are allowed to have a child visit their home.
• Home visits are not allowed during the first three months of the match.
• The volunteer, child and parent/guardian must meet with BBBS staff to review child safety policies before home visits may proceed.
• A child may do activities in common areas (e.g. TV room, kitchen, yard).
• Under NO circumstances should a child be allowed in a bedroom.
• Adult literature, videos, photographs or any adult themed items or alcoholic beverages must be inaccessible to children.
• No overnight visits are allowed.