Parent/Guardian Permission form for Teen participation in Sources of Strength
The Sources of Strength program is an evidence-led, widely used national best practice program. More than 10,000 youth leaders have participated from across the U.S. and Canada. This form describes what you may expect if your child participates. Please read this form carefully and ask any questions you may have before deciding.
What is Sources of Strength?
Sources of Strength is a training program that brings peer leaders together in partnership with caring adults. The program uses a fun-filled style of active learning to encourage open discussion about the very real problems that youth face and about identifying the sources of strength that are often helpful for those problems. It also lets students experience different ways of coping with problems that they themselves may have. For youth that are in distress and may be considering ending their lives by suicide, this program provides concrete steps about how this person can receive help from trusted adults and how as peers they can connect friends to help and support. The program will be led by a certified trainer and adult leaders already trained in the program.
Benefits of Participation
Your child will learn about challenges facing youth, including themselves and sources of support that can help. They may also learn about the importance and benefits of seeking help from trusted adults. Ultimately, Sources of Strength is a wellness program designed to help youth identify and strengthen protective factors in their lives, and leverage their voice to help create positive change in their lives, their community and their schools.
Possible Risks and Discomforts
We will be referencing the issue of suicide during this training. Most students find the training very upbeat, positive and quite different than expected. This training is not designed as a therapy group nor a time of sharing traumatic stories, however if discussing issues faced by many young people should upset them or if a student needs support during the training, trained adults are available to assist.
Your privacy is very important to us. We will remind all participants that any personal stories shared should remain with the group and any information obtained on evaluation surveys is confidential. The results of any group evaluation of the effectiveness of this training and subsequent activities may be presented at meetings or in future publications; however, your child’s name will not be used nor any identifying information about them without expressed permission.
Who should I call if I have questions?
You can talk to a representative of the Ryan Bartel Foundation on 571-207-8764 or email the Ryan Bartel Foundation at valwalters@ryanbartelfoundation.org.
Voluntary Participation
Taking part in this program is completely voluntary; you can withdraw at any time for any reason.
The Sources of Strength program that your child will be participating in is the same Sources of Strength Program the Ryan Bartel Foundation is helping implement in partnership with LCPS across the entire county. At the schools, the trained peer leaders are working on school wide initiatives to spread the messaging of HOPE, HEALTH and STRENGTH to impact and positively change social norms and behaviors. This is an opportunity for every teen to benefit from the direct training in the program, empowering them to either get involved more at their school and/or put into practice the principles learned, enabling positive, emotional strength building into their own lives.
RELEASE AND WAIVER
I have read this entire form. By submitting this form, I acknowledge that The Ryan Bartel Foundation is a charitable organization under Virginia law and that I (or a parent/guardian acknowledges for children under 18 years) am a beneficiary of this Foundation program. I hereby release and discharge The Ryan Bartel Foundation and its directors, officers, employees, affiliates, members, agents, volunteers and representatives, of and from any and all liability for any claims, demands, losses or damages, incurred by me or by my child in connection with any aspect of this Foundation program. I also agree to indemnify the Foundation and its directors, officers, employees, affiliates, members, agents, volunteers and representatives and hold them harmless against any claims for injuries to self or others caused by my (or my child’s) actions while participating in this program. I further authorize and consent to the use of any materials, whether by videotape, film, newsprint, written advertisement, or otherwise, containing mine or my child’s name or picture, and I release The Ryan Bartel Foundation and its directors, officers, employees, affiliates, members, agents, volunteers and representatives from any claims I might have due to initial or subsequent publication of any such materials.
