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Child/Youth Annual Update Form for Community Mentor Program - Big Brothers Big Sisters of Victoria Capital Region
  • About Us
    • How to Reach Us
    • OUR BOARD & COMMITTEES
      • Annual Reports & Financial Statements
    • FUNDERS AND PARTNERS
    • Complaints, Privacy and Whistle Blower Policies
    • CAREER OPPORTUNITIES
    • Sign Up for Our Newsletter
  • What we do
    • Bigger Together
    • Our Programs
    • Volunteer as a Mentor
    • Enrol a Young Person in our Programs
      • Community-based Mentoring
      • Go Girls Online
      • School-based Mentoring
    • Stories
      • Share your Story
  • Ways to give
    • Donate
      • Donate Securities
      • Corporate Partnerships
    • Other Ways To Support Us
      • Donate your Birthday to Big Brothers Big Sisters!
      • Partner With Us
      • Donate a Car
      • Bottle Depot
      • Move For Mentoring
  • Clothing/Furniture Collections
    • Auction
    • Calendar of Events
    • Collections
    • Who We Are
Donate Volunteer

Child/Youth Annual Update Form for Community Mentor Program

Child/Youth Annual Update Form for Community Mentoring in the Capital Regional District (Port Renfrew to Sidney)

  • Section A: File Update

    To be eligible for a mentor, your child must be aged between 7 and 16 years old and live in the Greater Victoria Area (from Port Renfrew to Sidney).   Submitting this update form does not guarantee that a mentor can be found for your child.
    If your answer is no, please go to Section B at the end of this form and hit submit
  • The child/youth must in Greater Victoria (Port Renfrew to Sidney) to receive service from this Big Brothers Big Sisters agency.
  • Stay informed of what's happening at BBBS! Fundraisers, Big/Little events, amazing opportunities and more! *Please note you can opt out at any time and we will not sell or share your contact information with anyone.
  • Activities List - Fun Things to Do Together

    Please select the activities, events and/or places your child enjoys or would like to try with their mentor:
  • We do not match girls with male mentors as we always have a considerably higher number of boys on our wait-list.
  • ABOUT YOUR CHILD'S EXPERIENCES

    You do not have to complete this section if you are not comfortable sharing information about your child or family with us. However, we strive to match each child with the best available mentor and knowing more about your child’s experiences helps us determine who might be the best match for them.
  • Please check all that apply.
  • Please check any/all that apply to this child.
  • Please check any/all that apply to this child.
  • Covid-19


  • By signing this Assumption of Risk, Release and Indemnity Agreement, you (on behalf of a mentee (the “Participant”), if applicable) are waiving important legal rights, including the right to sue. Please read carefully. This agreement must be completed in full before you (or the Participant, as applicable) can take part in any further in-person meetings with mentors that are authorized by Big Brothers Big Sisters of Victoria Capital Region (respectively, “Meetings”, “Mentors”, and the “Agency”).

    As of March 19th, 2020, the Agency suspended all Meetings in connection with the COVID-19 pandemic. As of June 1st, 2020, the Agency has resumed Meetings in accordance with the health and safety guidelines from British Columbia’s Ministry of Health and the Provincial Health Officer. Notwithstanding the Agency’s efforts to reduce risks in connection with the Meetings, the Participant or the parent/guardian named below, as applicable (the applicable person referred to as the “Undersigned”) recognizes that Meetings could expose the Participant to certain risks, including but not limited to the risk of contracting COVID-19, which may result in serious illness or death.

    Therefore, in consideration of the Participant participating in any further Meetings and for other good and valuable consideration (the receipt and sufficiency of which are hereby acknowledged by the Undersigned), the Undersigned hereby:

    Freely ASSUMES ALL RISK in respect of the Participant’s participation in the Meetings;

    RELEASES AND FOREVER DISCHARGES the Agency and all of its predecessor, subsidiary, parent, related, affiliated and successor companies, including but not limited to Big Brothers Big Sisters of Canada (collectively, the “Organizations”) and all of their respective present and former officers, directors, employees, volunteers (including Mentors), representatives and agents of the Companies (collectively, the “Released Individuals”) (the Organizations and the Released Individuals are collectively referred to as the “Released Parties”) from any and all responsibility, liability, cause of action or claim of any kind whatsoever in respect of the Participant’s participation in the Meetings due to any cause whatsoever including negligence or breach of any other duty of care on the part of the Agency or the Participant’s Mentor and including the failure of the Agency or the Participant’s Mentor to safeguard or protect the Participant from the risks, dangers and hazards associated with the Meetings;

    INDEMNIFIES all of the Released Parties from and against any and all liability incurred by any or all of them as a result of, or in any way connected with the Meetings; and

    Agrees that the provisions of this agreement shall enure to the benefit of the respective successors and assigns of the Agency and the Participant’s Mentor and shall be binding upon the Undersigned’s heirs, next of kin, executors, administrators and personal representatives.
  • By entering your name you are confirming you agree to the above terms and conditions. (If the Participant is a minor, this form is to be signed by the Participant’s parent or guardian) If I am signing on behalf a minor Participant, I represent that I have legal capacity and authorization to act on behalf of the Participant. By entering your name on behalf of the Participant, you are confirming they agree to the above terms and conditions.
  • MM slash DD slash YYYY
  • By entering your name you are confirming you witnessed the Participant's Parent or Legal Guardian sign the consent form. Witness needs to be over 19 years of age.
  • MM slash DD slash YYYY
  • Section B: Submit Form

  • MM slash DD slash YYYY
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Big Brothers Big Sisters of Victoria Capital Region
230 Bay Street Victoria BC Canada V9A 3K5
Email: Please use "Contact Us" Link below Telephone: 250-475-1117 Contact us toll free: 1-877-475-1114 Clothing Collections : 250-385-7226
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Charitable Business Number: 106793540 RR0001
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