Dear Parents/Guardians,

Big Brothers Big Sisters offers group programs throughout the school year. A group of 5-10 students will be facilitated by 1-2 leaders (female leaders for Go Girls and male leaders for Game On). This school year group sessions will be on a virtual platform (ZOOM) and, if it’s safe to do so, we’ll also provide in-person physically-distanced programming. The program will consist of seven to ten, 1.5 hour sessions. Each session will be fun-filled, active, and informative.

The program strives to do the following:
• create appreciation for the benefits of an active, healthy lifestyle
• build understanding of what constitutes healthy eating habits
• promote the importance of positive mental activity and regular physical exercise
• encourage awareness of core values, personal interests, strengths and attributes
• support the development of leadership and life skills
• offer guidance in establishing and maintaining friendships
• encourage leadership skills and independent thinking

The first session will include training around child safety information reviewed in the Strong from the Start program through Big Brothers Big Sisters. Please contact the office at 250-748-2447 if you would like more information about the child safety training.

For any in-person sessions held at the school, each group participant will require running shoes and comfortable clothes.

As part of the program, participants will be asked to complete an evaluation form telling us about their experience with the program. This information could be used to make program improvements and determine impact.

Please note we do provide snacks as part of the in-person sessions; please alert us to any allergies.

To register for this program, please complete and submit this form. Your child may withdraw from the program at any time. Should you wish to learn more about this program please contact Big Brothers Big Sisters of the Cowichan Valley at 250-748-2447.

  • Response to this question is voluntary. Information will be used for statistical purposes only.
  • At what phone number can we reach you during the day?
  • Please provide details.
  • This information will help our group facilitators best support your child.
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  • Informed Consent

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  • ASSUMPTION OF RISK, RELEASE AND INDEMNITY AGREEMENT

  • Child/Youth
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  • ASSUMPTION OF RISK, RELEASE AND INDEMNITY AGREEMENT - CONSENT

    The information being collected by the Agency is being collected for the express purpose of operating the mentorship program and will be used and may be disclosed to staff and volunteers as required for such purpose.
  • Media Consent

  • I hereby consent to Big Brothers Big Sisters of Canada (National Office) and its associated member Big Brothers Big Sisters of Big Brothers Big Sisters of Cowichan Valley the use of any photographs, audio and/or video recordings of my child or youth as taken or produced by media personnel and/or National Office or Local Agency staff at recreational events or match outings, or otherwise authorized by the National President & CEO, local agency President/Executive Director/CEO or Board of Directors, and that this media may be used by Local Agency and/or by the National Office for purposes of promotional material including brochures, posters, newsletters, media information, advertisements, audio-visual productions and digital media, (such as the local agency websites and social media). Photographs or video productions may also be shared with community and school partners for program promotion. Note: It is the parent/guardian’s responsibility to notify the office if the status of this consent changes.