Child/Youth Enrollment

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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. 
Hidden Fields
To look up the owner's email for notifications
For notifications
Youth Information
Enter a date in the following format: mm/dd/yyyy
This is the year the youth will graduate.
Press CTRL while choosing to select multiple
Guardian Information
Type NA if unemployed
Family Information
Physical Address
Existing Household Members
Please choose this child's relationship to the following people:


Emergency Contact

Parent/Guardian Agreement

  1. For the volunteer matched with my child, who has been screened and approved by Big Brothers Big Sisters, to transport my child to events and match activities (Community Based only)
  2. I understand if my child is enrolled in the Site-Based/School Based program that they are not allowed to see their Big (mentor) outside of school property in a one-to-one setting unless supervised by a BBBSU staff member.
  3. For the school to provide social and academic information about my child to Big Brothers Big Sisters (e.g. report cards, behavior reports);
  4. To have my child participate in an in-take interview conducted by Big Brothers Big Sisters staff and complete questionnaires throughout his/her time in the program containing questions about school, home life, and personal interests;
  5. To have my child talk with a Big Brothers Big Sisters staff person about personal safety;
  6. For BBBS staff to provide contact information for me and my child to the volunteer.
  7. For BBBS staff to use my child’s photograph and first name for the purpose of publicity efforts.
  8. I give my permission for use of the BBBS App to communicate with child, parent, volunteer, and match specialist through our online management system, Matchforce. 

I understand that the program is not obligated to match my child with a volunteer and that as part of the enrollment process I will be asked to provide additional information through an in-person interview. I understand that the information I provide in the enrollment process will be kept confidential, unless disclosure is required by law and with exceptions noted.  I understand that incidents of child abuse or neglect, past or present, must be reported to proper authorities. I understand that certain relevant information about my child will be discussed with the volunteer who is a prospective match (i.e. demographic information, information relevant to volunteer preferences, and information relevant to child-safety and well-being).

 

I certify that all of the information on this form is true and correct and that all income is reported.  I understand this information is being given for the receipt of federal funds, that the information on this application may be verified, and that deliberate misrepresentation of the information may subject me to prosecution under applicable state and federal laws. I understand this information will not affect my qualification for the program.

 

I do hereby release the organization and its employees, agents, members, volunteers and all other persons on its behalf from any and all liability for any damage or injury which such child might sustain while participating in said program and activities, including but not limited to any liability to any right of action that may occur to such child directly, or to me as his/her guardian. I understand that this information may be shared with the school or with partnership agencies when applicable.

 

 

If my child is matched with a Big Brother or Big Sister I agree to support my child’s match by reviewing the program and safety information given to me by Big Brothers Big Sisters, communicating with Big Brothers Big Sisters staff as outlined in expectations (which includes communication at least once a month in the first year of the match), and immediately reporting any concerns I might have to Big Brothers Big Sisters staff.

Medical Release


A potential Big shall be in a state of physical health which will allow the Big to safely engage in some variation of activities with a Little Brother or Sister and to safely transport and supervise that child. If a Big applicant is under the care of a physician or is taking prescription medication, the Big may be required to submit a physician’s statement before continuing further in the application process.
If a parent discloses their child has a communicable disease, that information will be disclosed to the potential Big with parent permission. If a volunteer discloses having a communicable disease, that information will be disclosed to the parent of that child with the volunteer’s permission. Having a communicable disease is not reason for denial and will be handled on a case by case basis after consulting the Program Director and Chief Executive Officer.

Request for Service

I hereby request the services of Big Brothers Big Sisters and give my permission for the volunteer from Big Brothers Big Sisters, to take my child on outings. I give my consent for any emergency medical care and/or surgical treatment, which might be deemed necessary due to an accident, injury, or sudden illness occurring during an outing. I will not hold Big Brothers Big Sisters liable for such medical and/or surgical treatment in such case of injury, illness, accident, or any emergency situation. I am familiar and in accord with the aims and procedures of the Big Brothers Big Sisters program. I would like to have my child participate in the program.                                                       

 




Confidentiality Policy

BBBS respects the confidentiality of client and volunteer records and, with the exception of situations listed below, shares information about clients and volunteers only among the agency’s professional staff. The right to confidentiality applies not only to written records, but also to video, film, pictures or use of client or volunteer's names in agency publications. All records are considered the property of the agency and not of the agency workers, clients, or volunteers themselves.

       Limits of Confidentiality Information will be released under the following circumstances:


1. Upon presentation of an authorized "Consent to Release Information" form signed by the parent/guardian or volunteer.


2. For promotional purposes with a signed copy of the “Consent to Use Identifying Information” form.


3. For purposes of program/case review, evaluation, audit, or accreditation to Big Brothers Big Sisters of America, the Board of Directors, Program Committee and funding sources.


4. Pursuant to a valid and enforceable subpoena.


5. To agency legal counsel in the event of litigation or potential litigation involving the agency. Such information is considered privileged information and its confidentiality is protected by law.


6. Identifying information necessary to comply with state laws mandating reporting suspected child abuse. The agency staff will follow reporting requirement of their respective jurisdiction and will comply with mandated procedures.


7. Upon receipt of information that a client or volunteer may be dangerous to himself/herself or to others. Necessary steps may be taken to protect the appropriate party, which may include a medical referral or a report to the local law enforcement authorities.


8. At the time a child or volunteer is considered as a match candidate, the following information is shared between prospective match parties.  Volunteer: Age, gender, race, religion, sexual orientation, interests, household composition, reason for application, special skills, life threatening illnesses, employment and specific information that would affect the match relationship; Parent/ client: age, gender, race, religion, interests, living situation, needs and expectations for the match, life threatening illnesses, and school or family information that would affect the match relationship. A copy of this information profile sheet will be provided to you at your request.


         I agree to keep all information regarding a potential Big Brothers Big Sisters match confidential. I will not discuss this information with any other person other than the assigned professional staff. I have read and understand the above document.  I agree to program participation under the conditions it sets forth.

Media Consent

Social Media Consent 

Social media sites are open lines of communication. Therefore, as representatives of Big Brothers Big Sisters, it is imperative that those engaging on social media sites follow these guidelines:


 1. Be Responsible. Be thoughtful about how you present yourself, your agency, and our organization. When in doubt, don’t.


 2. Be Respectful. Make sure that whatever you post will add a net positive to the discussion and not a negative. It’s okay to disagree with others, but being rude or disrespectful – i.e., cutting down or insulting an organization, staff, volunteers, donors, or supporters – is inappropriate. When a user escalates a situation, work to diffuse the situation by channeling it into an offline conversation. Remember that everything posted is public.


 3. Be Resourceful. Add value and spread the news about what your agency is doing. Link to press releases, blog postings, applicable news articles, partner events, etc. Your participation should help promote your agency and the network, assist the supporters or visitors who reach out to you, and help to build a sense of community. Participating in social media gives you the opportunity to share a lot of valuable information.


4. Be Smart. Use your best judgment when deciding what information to publish or spread. Know that there are consequences to what you publish. What you write could spread virally and will be public for a long time. It can be attributed to you and the organization in other published forms. Be respectful to the organization, staff, volunteers, children, families, donors, partners, and supporters.


 5. Respect Privacy of Others. Protect confidences and personal privacy. Only share information through social media that you know is appropriate for public consumption. Get approval before sharing information relayed to you by others. Always adhere to policies and ground rules related to confidentiality and child safety.


6. Be the first to respond to your own mistakes. Make sure that what you say is factually accurate. Clarify information that is incorrectly communicated and take responsibility if you are responsible for misstating fact.


Consent to Use Child's Identifying Information in BBBS Promotional Materials  

I, the legal parent or guardian, do herby give my permission for Big

 Brothers Big Sisters of the Upstate to use the following information about my family: name, picture, interest. This information shall be used by BBBS of the Upstate solely for promotional purposes. The permission granted by this consent form applies solely to the identifying information herein described and may not be used for any other purpose not provided for herein.



In giving this consent, I release Big Brothers Big Sisters of the Upstate, their nominees and designees, from any obligation or liability otherwise owed to me in connection with any personal or proprietary right I may have as a result of the sale, reproduction or use of the above referenced identifying information. This consent may be terminated in writing at any time.

Appointment Policy 

If you have an appointment at any point during the enrollment process, and you do not call within 24 hours prior to the appointment to reschedule/cancel, the agency has sole discretion to decide if/when that appointment will be rescheduled and if/when the child will be eligible for enrollment.

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