Lunch Buddy

Training & Consent

You are required to complete the form and watch the entire training video below prior to attending your first Lunch Buddy luncheon.

Lunch Buddy Consent Form

Your Name*

First Last

Email*

Timeliness Consent*

Please arrive at least 10 minutes before your Lunch Buddy group and check into the office or other designated area. You may need a name tag, etc.

I understand.

Lunch Purchase Consent*

You may purchase a school lunch, costs vary, or you may bring your own lunch. You may NOT bring fast food or take-out food into the school (i.e. McDonald's, Subway, etc).

I understand.

Availability Consent*

If you are unable to participate on a Lunch Buddy day, please contact Lisa Denzer by phone or text, 952.380.6647 or by emailing RUSCKinship@gmail.com as soon as possible.

I understand.

Photography Consent*

Mentors are not allowed to take pictures of student Lunch Buddies.

I understand.

Location Consent*

Mentors are not allowed to go off on their own with the students.

I understand.

COVID-19 Consent*

We will follow the School Covid-19 decisions as outlined on the school website.

I understand.

Promotional Consent*

I understand that RUSC Kinship Mentoring often takes photographs at the time I am enrolled in the program, at the time of the match, and at Kinship events and parties. These photographs may be used at a later time for publicity/promotion purposes. I give permission for RUSC Kinship to use my photo for publicity/promotion purposes. This may also include, but not limited to publication in a local newspaper, magazine, the RUSC Kinship website, newsletter, social media, promotional items, or poster/billboard. If names are used, I will be identified by first name only, unless specific permission to use first and last names is granted. Pictures of the lunch buddies will be taken in the Spring. Parents have the option of sharing a copy of the picture with the adult Lunch Buddy.

I understand.

Mandated Reporting Requirement Consent*

RUSC Kinship takes the safety and welfare of the students we mentor very seriously. Therefore, we ask that you watch the video on this page that explains MANDATED Reporting. If you encounter anything while you are with your Lunch Buddy, please report the matter to Stevens County Social Services or contact Lisa Denzer, RUSC Kinship Director for assistance

I understand and will watch the video prior to my first Lunch Buddy event.

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Lunch Buddy

Training & Consent

Lunch Buddy Consent Form

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