Roots Mentoring – Child Application Form

Roots - Child Application Form

If you are interested in registering a child for the Roots program virtually this 2020-2021 school year, please fill out the following form. An electronic waiver will be sent to the Parent/Guardian upon submission, and this waiver must be returned to Big Brothers of Greater Vancouver staff prior to the student participating in our programs. During the COVID-19 pandemic, an additional participatory waiver must also be signed. These waivers will be sent to the e-mail address provided.
  • MM slash DD slash YYYY
  • Emergency Contact

    Please ensure this person is someone other than the parent/guardian, and they must have a phone number that is different from the parent/guardian.
  • The following optional information is asked for statistical purposes and for grant/funding support. The questions and responses do not indicate or affect participation requirements.

Please connect with us if you have questions:

Danielle Olson
Site Based Lead & Supervisor
(604) 802-8839 or Danielle.Olson@bigbrothersbigisisters.ca

Scroll to Top