ISM Parent/Guardian Renewal/Cancellation Form "*" indicates required fields Your child was matched at their school with a school-based mentor from Big Brothers Big Sisters of Victoria Capital Region during the 2023-2024 school year. At this time, we believe that it will be possible for your child and their mentor to continue meeting together for one hour/week during the 2024-2025 school year as well. If you want your child to continue in the program, you do not need to do anythingI want changes to my child's participation in the program during the 2024-2025 school year: I do not want my child to have a mentor this year, or I do not want my child to have the same mentor this year Parent/Guardian Name:* First Last My Child Lives in:* Comox Valley Salt Spring Island Sooke or the West Shore Victoria or Saanich Brentwood Bay or the Peninsula My Child Attends School at:* Braefoot Brentwood Bay Brooklyn Campus View Craigflower Cloverdale Traditional George Jay Marigold Quadra Queneesh Saseenos Salt Spring Sundance Bank South Park Valley View Vic West Home Address: Street Address City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Phone:*Email: Name of Child:* First Last By entering my name below, I am acknowledging that:*I, the parent/guardian of the child named above, am removing my permission for my child to be matched with a mentor through the In-School Mentoring Program at Big Brothers Big Sisters. First Last Signature*Signed on this date:* MM slash DD slash YYYY CommentsThis field is for validation purposes and should be left unchanged.
