Building BIG Leaders: BIG Leaders Connect!

Building BIG Leaders: BIG Leaders Connect! is a fun and interactive 4-week virtual experience to help students build confidence, develop leadership skills, and get ready for high school life. Through real conversations with high school mentors, workshops, and peer connection, students will learn how to grow as leaders! Topics Include: Transitioning Into High School; Mentorship & Healthy Relationships; Building Confidence & Communication Skills and more!!

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Youth's Name*
MM slash DD slash YYYY
Adding your child’s email will allow them to receive the Teams link for the program and receive weekly reminders to attend the sessions.
Youth's Grade*
First and Last
Relation to Child*

I am the parent/guardian of the child for whom I am making this application.*

Online Program Consent

As the parent/guardian, I understand the following rules will be reinforced during the first session and periodically throughout the program: 1) Youth are not permitted to share information about one another outside of the program. 2) I agree to support and encourage my child to participate in each session. 2) Provide support or feedback to my child if required. 3) Check in with my child following each session to determine how they are responding to the program. 4) Contact BBBSPY immediately should any concern arise from my child’s participation in this program.
By checking YES you providing your consent for your child to engage in the Virtual Building BIG Leaders: BIG Leaders Connect Program. You are also giving your consent for your child to have virtual contact with other group participants during program sessions.*
You are encouraged to review Microsoft’s privacy policy which can be found here: https://privacy.microsoft.com/en-ca/privacystatement. Each program is supported and monitored by a BBBSPY Program Staff member.

Media Consent

I hereby consent to Big Brothers Big Sisters of Peel York (BBBSPY), the use of any photographs, audio and/or video recordings of my child taken during the program as authorized by the BBBSPY President & CEO or Board of Directors. I give my permission for this media to be used by BBBSPY for purposes of promotional material including brochures, posters, newsletters, media information, advertisements, audio-visual productions and digital media, (such as the BBBSPY website and social media). Photographs or video productions may also be shared with community and school partners for program promotion.*

Informed Consent

I hereby give permission to Big Brothers Big Sisters of Peel York to make available their service to my child. It is my understanding that the intention of the Agency is to offer my child an opportunity to participate in a group program lead by a responsible adult, (minimum 18 years old, however, where appropriate supervision takes place, the volunteer may be younger), I understand that all efforts will be made to select a responsible Mentor who will facilitate the group program. In consideration for this service and other valuable consideration provided to my child by Big Brothers Big Sisters of Peel York, I release the agency of all responsibilities and liabilities in connection to their services provided in good faith, to myself or my child. I permit the agency to release any relevant information, including my personal information, to Big Brothers Big Sisters of Canada and their insurers, as may be appropriate in connection with any legal proceeding, inquiry or risk thereof. I understand that the collection of personal information about me or my child will be held in strict confidence and is to be used solely for the purposes of administering the program. I further agree that information about my child may be shared, at the discretion of Big Brothers Big Sisters of Peel York, with the group facilitator so that my child’s needs may be best met. I understand that this application is the property of Big Brothers Big Sisters of Peel York. I also agree that my child will participate in the Pre- Match Training Program administered by Big Brothers Big Sisters of Peel York.*
Clear Signature

OPTIONAL SECTION: STATISTICAL INFORMATION

Youth's Birth Place