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;
13. I understand that records are not available for review by clients, parents/guardians, and/or volunteers.

• I will disclose any firearms owned by me or stored in my home to BBBS7RR at the time of my enrollment and immediately if acquired, throughout the life of the match.
• Possession of any firearms/weapons will be disclosed to the child's parent/guardian by the case manager at the time of match presentation, prior to match approval.
• I attest to the fact that any weapons, firearms, or ammunition owned by me or stored in my home are licensed, permitted, registered, handled, and properly stored in accordance with all applicable state and federal laws. 
• *In the case where a law enforcement official is required to carry a weapon at all times as a condition of their employment, BBBS7RR will document these requirements and notify and gain approval by the parent or guardian of the child prior to the match activation.

I agree to keep all firearms/weapons that may be in my home inaccessible to my Little. I will do this by assuring that the following precautions are taken:

• All firearms/weapons in my household will be unloaded, locked-up, and inaccessible to my Little.
• All firearms in my household are registered when legally required.
• Any bullets or ammunition in my household will be locked-up separately from the firearms/weapons and will be inaccessible to my Little.
• My Little will have no knowledge of firearms/weapons being stored in my home.
• I will not carry a weapon on me during any match activity with my Little, even if I have a concealed carry permit.
• If I am a site-based Big, I will not bring a weapon with me when I visit my Little at the site.

If firearms are used for any activity:

• My Little will have completed a gun safety course or equivalent and provide documentation to BBBS7RR.
• Your Program Specialist must be notified of and provide agency approval before engaging in an activity in which firearms are involved.
• The firearm will be transported to and from any activity in compliance with state and federal laws and in a manner in which the Little cannot gain access to the firearm.
• I will closely supervise my Little any time they are handling a firearm. Both the volunteer and Little will observe all safety precautions during the activity.

I realize that if there is a firearm/weapon in my household, even if I am not the owner, I am responsible for taking these safety measures throughout the duration of my match.  I understand that this agreement may be discussed with the Little’s parent or guardian in the match proposal call and will be monitored by BBBS7RR staff in follow-up calls.

I, for myself, my heirs, executors and administrators, hereby release and forever discharge BBBS7RR, its officers, directors, employees and agents, and all other personnel, companies, schools, organizations, law enforcement and other agencies and their officers, directors, employees and agents from any and all causes of action, suits, damages, liabilities, costs, debts, sums of money, claims and demands of any sort whatsoever, and any and all related attorney's fees, court costs and other expenses, in each case that result from or relate to my relationship with any youth I volunteer to mentor or that otherwise result from or relate to my services as a volunteer or my application to become a volunteer. 

I understand that as a BBBS7RR volunteer I am required to submit a valid copy of my driver's license and evidence of my automobile insurance to BBBS7RR prior to matching. I understand that I am required to maintain a valid driver's license and automobile insurance throughout my participation in the Big Brothers Big Sisters program, and that I will be responsible for promptly notifying BBBS7RR of any change in my driver's license or automobile insurance, as well as any arrest or conviction for a moving violation. I release BBBS7RR and any agents of BBBS7RR, companies, schools, organizations, law enforcement and other agencies and their officers, directors, employees, and agents from any liability that may result as a result of any automobile accidents that may occur while I am volunteering with BBBS7RR.

I give permission for any staff member of BBBS7RR to review all information contained in my volunteer file for the purpose of matching, evaluation, program audit and staff training. I also give permission to the staff and agents of Big Brothers Big Sisters of America (BBBSA) to review my volunteer file in connection with their periodic audit for purposes of evaluation. 

Sharing stories and celebrating your success is an important part of our mission!

I understand that all information obtained from me or about me will be held in confidence by BBBS7RR. I will only have access to my application. All other information concerning me, including but not limited to information derived from my references, the investigative process, interviews or otherwise, will be the sole property of BBBS7RR. BBBS7RR will not release to outside sources, unless required by law, information from my volunteer file other than verification that I am a volunteer, without my prior written consent.

As a Volunteer Big, I understand that personal information about the Little I am matched with, and/or their family, should be held in confidence.  I understand that this confidentiality policy does not include Big Brothers Big Sisters agency staff who I might speak with regarding any circumstances of my match. Information that I share with people I know will be limited to information about the types of activities that my Little and I do together and will not reveal personal information that my Little shares with me.  When speaking to people I know about my Little, I will only use their first name and will not identify where my Little lives.

I have read the above statement and understand Big Brothers Big Sisters of the 7 Rivers Region's policy regarding confidentiality of my Little’s personal life.  I agree that I will fully adhere to the terms of the policy as a condition of my involvement with the agency and understand that failure to comply with this policy may result in a severance of my relationship with the agency.  This statement shall remain in full force and effect for the entire duration of my involvement with Big Brothers Big Sisters and thereafter.

Anyone may voluntarily report suspected child abuse or neglect to the local child protection or law enforcement agency. Wisconsin and Minnesota law requires professionals who work with children and families and their delegates (this applies to BBBS7RR staff and all our Bigs) to make a child protection report if they know or have reason to believe.

• A child is being neglected or abused.
• A child has been neglected or abused within the preceding three years.*

Anyone who has reason to believe that a child has been threatened with abuse or neglect and that abuse or neglect of the child will occur may report.

Visits to the volunteer’s home are strictly prohibited for the first 3 months of a community-based match.  Parent/Guardians are not permitted to allow home visits within this timeframe.  After 3 months of consistent match outings (2-4 per month), volunteers must have the documented consent of the Parent/Guardian and BBBS7RR permission is given by a Program Manager, the Program Director, or the Executive Director in order for home visits to occur on outings. BBBS7RR permission is based on an assessment of the match relationship and is informed by a review of Match Support Contacts and surveys completed by match participants; there must be no overdue Match Support Contacts, and all required surveys must be completed. Any violation of this policy could result in immediate closure of the match.

Site-based program – activities outside the designated location (school or workplace) are prohibited including visits to the mentor’s home.

BBBS7RR maintains a prohibition on matched Volunteer mentors being under the influence or using any substance (including alcohol, illicit drugs, and legal drugs, including medical marijuana, “legalized” marijuana, and prescription medications) that could potentially affect judgment, driving, reaction time, or otherwise jeopardize a child’s safety and wellbeing, while their Little is in the Volunteer Big’s care or company. Violations of this policy will result in immediate termination of the match and a child abuse report may be filed for any illegal actions.

BBBS7RR prohibits all overnight visits involving a mentor and a mentee unless under specific approved circumstances. Exceptions to this policy are permitted in cases where one of the following specific criteria have been met AND the required written authorizations have been given and documented by BBBS7RR:

• There is genuine concern for the safety of a child returning to their own home (emergency circumstances such as dangerous travel due to weather or threat of imminent abuse or neglect)

OR

• An event is formally designated by the agency as one that (1) is of a nature to provide an exceptionally significant developmental or educational benefit to a child or youth, and (2) that the event would not be possible without the Big accompanying the Little (i.e.: a college visit)

As a BBBS7RR volunteer, I am required to take the following child safety pre-match training prior to match activation:

• Pre-Match training for Volunteers
• State of residence Mandated Reporter Certification Course

Accommodations will be made in cases where online courses pose a barrier for a volunteer.

After I am matched, I will be required to complete a minimum of one documented child safety training each year. BBBS7RR will provide several opportunities to complete all training both in-person and virtually.

I understand that as a BBBS7RR volunteer I am required to notify BBBS7RR promptly of any changes in the information I have provided during the application process that may alter my ability to serve in the capacity for which I have applied, including any changes in medical, psychological, arrest history, general contact information. I understand that such information may be released to the parent or guardian of a child with whom I am matched, and I consent to the release of such information.

Please proceed thoughtfully and never post any pictures of a Child, Parent or Volunteer online unless you have the consent of the child, parent/guardian, and the volunteer. Participants are encouraged to be mindful that many people are sensitive to having their personal information and photos shared via social media. BBBS7RR requires Bigs to receive direct permission from the parent/guardian when sharing photos of their Little. 

Please exercise sound judgement when using social media. Volunteers are serving as a role model for their Little and for the community. Ensure all content is appropriate and child friendly. Anything participants post could potentially have a negative impact on BBBS7RR. Volunteers, please be mindful that no inappropriate language, behavior, sexual references, seemingly drunk behavior, night club activities, messages on t-shirts, etc. should be referenced or shown in pictures, whether you are partaking or not. As a volunteer, you are a representative of BBBS7RR and should reflect this through all of your social medial messages and content including what others post on your sites.

BBBS7RR advises you to set your social media settings to the highest privacy setting, if applicable. However, do not assume that things you publish on a private personal profile cannot be accessed. No matter what settings are applied to your social networking sites, all it takes is for someone to copy and paste that information on to a public site. Generally, you shouldn’t post content that you wouldn’t want in the newspaper or TV. Please check individual site’s privacy settings.

Not all social networking sites are designed to support mentoring relationships. Please know that it is okay, and often advisable, to maintain a boundary of not connecting on social media. BBBS7RR strongly recommends Volunteer Bigs and Littles to not “friend” or “follow” each other on social media. Volunteers and Parents/Guardians are encouraged to discuss this boundary with the Little. Volunteers, please proceed thoughtfully if your match decides to connect through social media. You must follow these guidelines:

1. Get approval from the parent/guardian before connecting.
2. Ensure your Little meets the age requirement of the particular social media site.
3. Reevaluate your current social media sites regarding what information would be appropriate for your Little or their parent/guardian to see.
4. Refer to all prior guidelines to ensure safety, confidentiality, and parent/guardian consent before connecting or posting information or photos about your Little.
5. Please be aware that BBBS7RR strongly encourages parents/guardians to have access to their child’s accounts.
6. If you view information on the Little’s social media site that endangers the health, safety, or welfare of the Little (e.g. information or pictures of the Little engaged in underage alcoholic drinking, drug use, cyber-stalking, cyber-harassing, cyber-bullying, or inappropriate sexual behavior), you will (1) report the information to the Program Specialist; and (2) report the information to the Little’s parent/guardian, or other appropriate person or entity.  If it is an emergency, you will call 9-1-1 to report the information.

If a match is communicating via text or other instant messaging application, we recommend that the parent/guardian be included on all messages. BBBS7RR recognizes that some matches may elect to communicate via FaceTime, Skype, or other similar programs. If this is the case, the Little’s parent/guardian must always be aware of present during the call.

If participants are using social media inappropriately, BBBS7RR staff may coach, require changes, limit and/or prohibit communication on social media with other participants.  If you continue inappropriate social media use, your relationship with our organization could be terminated.

I understand that BBBS7RR reserves the right to reject a candidate for any reason that BBBS7RR, in its sole judgment, determines will or may affect either the best interests of a Little or BBBS7RR. Furthermore, BBBS7RR reserves the right to withhold the reasons for such refusal.