Virtual Club2Go: Parent/Guardian Consent Form
In an effort to continuously serve members while programs in the Club are limited, Boys & Girls Clubs of South Puget Sound (BGCSPS) is providing distance-based, virtual programming for Club members. Club staff will facilitate program activities through online platforms. BGCSPS will use software, tools and applications provided by third parties that members, parents/guardians and/or staff will access via the Internet and use for purposes of communication and programming. The platform that we will use to facilitate the LIVE programming is Zoom.
In order to participate in virtual Club programming, you will need to complete the permission form below. Once we have received your permission for your child(ren) to participate, we will send you the link to access the live feed through Zoom. In order to access the resources, you and your child will need a mobile device or computer with an internet/data connection. All LIVE activities will be monitored by staff making sure to protect member information. There is no advertising on Zoom, and no member information is collected for commercial purposes. All activities will comply with BGCA’s Internet Safety Policy (
) will use the online applications for the following program activities:
• Educational activities, tutoring support, basic art projects members can do led by staff, physical exercises, and simple active activities that members can do along with staff that members and families can watch or listen to live. Recorded sessions may be posted on the BGCSPS Virtual Club website.
If you have any questions, please feel free to contact our Support Services Manager, Katie Woods at
By completing this form, I affirm that I am the parent/guardian of the below Club member(s) and give permission for them to participate in the following distance-based online Club activities at Boys & Girls Clubs of South Puget Sound. While a virtual experience can provide important activities and social connections, it does not provide child care or guarantee physical safety. I understand that I should still plan for appropriate levels of supervision. In addition to posting activities on the website, we will be engaging through our Boys & Girls Clubs of South Puget Sound social media pages. Staff will not be engaging through personal communications (i.e. email) or social media contacts. Please ensure your child has your permission to access our online resources, and remind your child about the importance of safe internet use.
First & Last Name of Parent/Guardian
Parent/Guardian Phone Number
Parent/Guardian Email Address (this is the address the Zoom Link will be sent to)
Does your family receive Free or Reduced lunch?
I hereby give my consent to the Boys & Girls Clubs of South Puget Sound to use any photos or video that may be taken of my child (ren) or their work, while participating in the Virtual Club program.
Never submit passwords through Google Forms.
This form was created inside of BGCSPS.