Youth Application for Kinship

  • Youth Application for Kinship

    Updated for 2025
  • How did you hear about Kinship
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  • Biological Sex
  • Format: (000) 000-0000.
  • Emergency Contact's relationship to your child

  • Format: (000) 000-0000.

  • Parent Information

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Please mark parent status
  • Is your child's non-custodial parent living?
  • Is your child affiliated with a church?

  • Insights on your child

  • How would you describe your child? (check all that apply)

  • Are these areas of concern

    Has your child had (in the past 12 months) involvement and issues with any of the following areas?  If so, please explain.
  • Alcohol / Tobacco / Substance Abuse
  • Behavioral issues
  • Sexual inappropriateness
  • Bullying
  • Overuse of electronics

  • Goals for your Child

    Please consider these areas of your child's life (or the child this application is for). What goals would you like to set for improvement or changes in these areas? Examples could include learning a new hobby, improvement in grades or enthusiasm for school, etc.

  • This section should be completed by your child

    (Parent / guardian may help young children)
  • How would you describe yourself? (mark all that apply)
  • Mark all of the "Woods & Fields" activities you enjoy or would like to try.
  • Mark all of the "Indoor" activities you enjoy or would like to try.
  • Mark all of the "Heart & Soul" activities you enjoy or would like to try.
  • Mark all of the "Sports" activities you enjoy or would like to try.
  • Mark all of the "Going Out" activities you enjoy or would like to try.
  • Mark all of the "Getting Dirty" activities you enjoy or would like to try.
  • Mark all of the "Arts & Hobbies" activities you enjoy or would like to try.
  • Mark all of the "Animals" activities you enjoy or would like to try.
  • Mark all of the "On the Water" activities you enjoy or would like to try.

  • Consent for my Child to join Kinship

  • I understand the nature of the Kinship of Morrison County youth mentoring program and I want my child to participate in it.  In order to allow my child to participate I agree to the following:

    • I understand that my child will be participating in various one-to-one activities with his/her mentor & may interact with their mentor's family as well.  I expect my child to be under their mentor's supervision during those activities.
    • I undertand that my child will be participating in Kinship sponsored group mentoring activities along with other Kinship youth & adult mentors.  These activities vary greatly in topic and are supervised by Kinship staff.
    • I understand that every effort is made by Kinship staff & mentors to provide for reasonable care, protection and supervision of the children participating in the program, I release the volunteer mentors, staff & Kinship of Morrison County program from liability for incidents occurring while my child is participating in, going to or returning from a Kinship outing.

    Furthermore, I have read & accept the Kinship Code of Conduct & Release of all Claims (linked to below). I agree that all information on this form is accurate. I hereby authorize my son/daughter to participate in Kinship of Morrison County youth mentoring program on these terms. I further authorize Kinship staff & volunteers to seek emergency medical attention and release his/her medical records in case I cannot be contacted during a Kinship activity or outing with his/her mentor. This agreement is valid until December 31, 2024.

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