Leave the Legacy of Mentoring

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VULNERABLE SECTOR REFERENCE

If you have worked or volunteered with vulnerable people (children, elderly, people with disabilities) in the past 5 years, please provide us with a reference of someone who supervised you during this time. If you have NOT worked or volunteered in a vulnerable sector in the past 5 years, please provide an employment reference. This reference cannot be a family member.

PERSONAL REFERENCE

This should be a friend you have known for at least 2 years. This reference must not be a family member or significant other.

The child/youth you are mentoring is regularly forgetting to bring her school work to your weekly study sessions and has missed a number of sessions with you. As a result, you feel there is no progress being made in your time together.

An unexpected opportunity has come up for you that will affect your ability to fulfill your six month commitment to the child/youth you are mentoring.

You have been matched with your Little Study Buddy for two months and you get along really well. You also have a good relationship with her parents. After a study session, your Little's mom asks if it would be possible for you to also help her other daughter with her homework because she has noticed an increase in your Little's self-esteem. Your Little Study Buddy's mom also asks if you could drive your Little to her after-school rehearsal next Thursday because she is picking up an extra shift at work.

TO: Big Sisters of BC Lower Mainland (THE “AGENCY”)

In connection with my application to volunteer with the Agency (“Volunteer Application”), I provide and state as follows:

1. Acknowledgement and Consent. By signing this Agreement, I acknowledge, understand and accept that:
• a. There is no obligation on the Agency to accept my Volunteer Application or assign me as a volunteer into a mentoring program (a “Mentoring Program”);
• b. There is no obligation on the Agency to provide a reason for the denial of my Volunteer Application or assignment as a volunteer into a Mentoring Program;
• c. There is no obligation on the Agency to provide me with a reason or prior notice for terminating my involvement in a Mentoring Program;
• d. If I am accepted as a volunteer, my involvement in a Mentoring Program is not intended to create and shall not be construed as creating either an employee–employer relationship or a contract for services that would allow me to receive a salary, compensation or any benefits, monetary or otherwise; and
• e. The Agency and Big Brothers Big Sisters Canada (“BBBSC”) are separate entities and this Agreement is between me and the Agency.

2. Volunteer Position Description, Codes of Conduct and Confidentiality Agreement.

3. Background Check. For the purpose of considering my Volunteer Application, I consent to the Agency:

• a. Contacting the references, in confidence, included in my Volunteer Application;
• b. Conducting a criminal and other relevant background checks; and
• c. Collecting information from any Big Brothers Big Sisters agency with which I am, or was formerly involved, including a Big Brothers Big Sisters agency in another country with which I am, or was formerly involved.

4. Collection and Use of Personal Information. I consent to the collection and use by the Agency of my personal information for the purpose of evaluating and considering my Volunteer Application (including as described in this Agreement) and, if accepted into a Mentoring Program, for the purpose of administering the Mentoring Program. I consent to the Agency using my personal information to periodically keep me informed about the Agency, BBBSC and BBBSC’s member agencies, including programs, services, opportunities to volunteer, events, funding needs and membership benefits.

I understand that I can withdraw my consent to the receipt of promotional information from the Agency at any time by contacting the Agency.

I further understand that the Agency will retain the information in my file, including my personal information, for a period of 75 years from the date I cease to be involved with the Agency, after which time my file will be destroyed. Examples of personal information collected by the Agency include: (i) name, (ii) phone number(s); (iii) date of birth, (iv) contact address, (v) driver’s license and auto insurance information, and (vi) agency(ies) applied to and notice(s) of acceptance, rejection or withdrawal.

5. Disclosure of Personal Information. If I am accepted into a Mentoring Program, I consent to the Agency disclosing any relevant information, including any personal information held by the Agency, to:

• a. The parent(s) and/or guardian(s) of a child with whom the Agency may consider “matching” me in a Mentoring Program. If I am considered for a site-based Mentoring Program, I consent to the Agency disclosing any relevant 10 information, including any personal information held by the Agency, to representatives of the respective school or institution;
• b. BBBSC, and to the Agency’s and BBBSC’s insurers and/or legal counsel, as may be appropriate in connection with any legal proceeding, inquiry, or risk thereof; and
• c. Authorized representatives of BBBSC during and in connection with periodic agency accreditation reviews.

I also acknowledge and agree that in the event the Agency ceases operations, any and all information about me held by the Agency will be disclosed to BBBSC, a BBBSC agency selected by BBBSC, or both. I consent to that disclosure and to the use of that information by BBBSC, the BBBSC agency selected by BBBSC, or both in accordance with the rights granted to the Agency under this Agreement.

6. Personal Vehicles and Property. If I am accepted as a volunteer in a Mentoring Program, I understand that neither BBBSC nor the Agency insures personal vehicles or property belonging to volunteers and that use of my personal vehicle(s) and property in connection with my participation in a Mentoring Program is at my own risk. I agree that I am solely responsible for my personal property and vehicle(s).

7. Assumption of Risks and Waiver of Claims. If I am accepted as a volunteer in a Mentoring Program, I agree that this Agreement constitutes an unqualified assumption of all risks, dangers and hazards associated with my work and participation as a volunteer in the Mentoring Program and my association with BBBSC or the Agency.

I release BBBSC, the Agency, and their respective directors, officers, employees, volunteers, agents and representatives (the “Releasees”), from any and all actions, causes of action, suits and all other claims whatsoever (the “Claims”), that I have or may have in the future against the Releasees, relating to or arising in connection with my Volunteer Application, the acceptance or denial of my Volunteer Application, my participation in a Mentoring Program, the Alumni Program, and/or my association with the Agency or BBBSC.

8. Indemnity. I will defend, indemnify and hold harmless the Releasees from all Claims of any kind relating to or arising in connection with my negligence or any act or omission of mine relating to or arising in connection with my participation in a Mentoring Program or my association with the Agency or BBBSC, including but not limited to the injury, illness, disability or death of any other person(s) and/or damage to or loss of their property or the property of the Releasees, and against all damages, costs, expenses and fees (including without limitation, reasonable legal expenses), losses, fines or penalties incurred by or on behalf of the Releasees in the investigation or defence of any and all Claims; provided that:

• a. the Releasees shall be entitled to participate in the defence of such claim and to employ counsel at my expense to assist in the handling of any Claim;
• b. I will obtain the prior written approval of the Releasees before entering into any settlement of any Claim or ceasing to defend against any Claim; and
• c. where I fail to acknowledge my indemnification obligation or to assume the defence of any Claim in a timely manner, the Releasees shall have the right to defend the Claim in such manner as they may deem appropriate, at my cost and expense (including payment of any judgment or award and the costs of settlement or compromise of the Claim).

9. Other Terms of this Agreement.

• a. In entering into this Agreement, I am not relying on any oral or written representations other than as set forth in this Agreement.
• b. This Agreement shall be governed by and construed pursuant to the laws of the Province in which the Agency is located.
• c. In the event that any provision or term of this Agreement is held to be invalid, illegal or unenforceable, the remaining provisions of this Agreement shall remain in full force and effect.
• d. The provisions of this Agreement shall be binding upon me and my heirs, executors, administrators and legal representatives and shall ensure to the benefit of and be enforceable by the Agency and BBBSC, and their successors and assigns.

10. Residency and Age Requirement. I declare that I am a legal resident of Canada. I acknowledge and agree that if I have not reached the age of majority of the Province or Territory in which I reside, my parent or legal guardian will also need to sign this Agreement in order for my Volunteer Application to be considered.

IMPORTANT:By typing my name in the line below, I acknowledge that I have read the terms of this Agreement, have been given an opportunity to obtain independent legal advice, and understand that it represents a waiver of certain legal rights, including the right to sue. I further agree that such limits are reasonable and sign this Agreement freely, voluntarily and without duress.