2024 HOST FAMILY AGR

HOST FAMILY AGREEMENT & ORIENTATION

(For Adults hosting youth and adults participating in CISV programs- PLEASE COMPLETE ALL INFORMATION)
CISV Homestay Goals

Thank you for choosing to be a host family for CISV visitors from all over the world. CISV's mission is to educate and inspire action for a more just and peaceful world. By being a host family for Interchange or for a homestay weekend for CISV camp participants, you participate in that mission. The purpose of homestay weekends is to introduce the visiting CISV delegates to USA culture, as well as to give them some time to relax in a family setting. It gives you and your family a sense of what CISV is about: learning from each other and sharing our cultures to achieve a more harmonious world.
Name of Person Completing Form*

First NameLast Name
Phone Number

Area CodePhone Number
Email
example@example.com
Address of Person Completing Form

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you accustomed to dealing with dietary restrictions? If so, describe which types (i.e., vegetarian, vegan, dairy-free, gluten-free, etc.)
Are you accustomed to dealing with allergies? If so, please describe (i.e., nut-free, dust, pollen, etc.)
Do you have pets in your home? If so, list type and number.
Restrictions on Certain Activities While Hosting

To reduce risk of injury, CISV participants should not use a trampoline. Host families who personally own and operate their own watercraft must have primary boat liability insurance in effect and should verify this coverage with their insurance agent. Our general liability policy excludes coverage for watercraft over 26 feet in length. CISV travel insurance does not cover injuries arising from motorcycle riding, scuba diving, skiing, mountain climbing, sky diving, hang gliding, paragliding, professional or amateur racing, or piloting an aircraft.
Please describe an activities you plan during the host phase that involves hiring watercraft (including rafting).
While in my care, the delegates will not participate in the activities listed above that are not covered by CISV travel insurance.

I confirm
Host Family Orientation

CISV Jacksonville has created a video orientation for families hosting delegates.
This video was specifically created for host families for Village (age 10-11) but it also applicable to host families for other ages. Please click this link to view the video: https://www.youtube.com/watch?v=6CvknWeoAYw
I have viewed the host family training available at https://www.youtube.com/watch?v=6CvknWeoAYw

I confirm
How to make the people you are hosting feel welcome
This is a list of ways to help your visitors have a great home stay.
- Make a welcome poster for the airport
- Give a tour of the home upon arrival.
- Review any household rules:
• Which areas of the house may they go into
• Is there an alarm system
• Do you keep your doors/windows locked
• Who to talk to if there is a question, concern, problem
• What to do if you feel sick
• What to do when parent(s) are working
• Is there a curfew

Privacy:
- Where is the delegates personal space especially if sharing a room
- Are there specific places or times where privacy is expected
English:
• Remember that your guest will need a break from English. It is hard to spend their whole day speaking/listening in a second language

Kitchen:
• Specify drinking water vs. washing water
• When are meal times
• Who cooks
• Where are the glasses/plates/silverware
• Where is food allowed
• What to do with dishes/silverware/glasses after their use
• Is it okay to help themselves to what’s in the fridge or cabinets
• What to do when done eating
• Do you eat out

Bathroom:
• Locations
• How to work the shower (this should be done on the first day)
• Where to store their personal bathroom needs
• Where to get shampoo, conditioner, soap, toothpaste, lotion, towels, etc (clarify which items are for what if your guest does not speak English well)
• How to flush the toilet and that it is okay to flush toilet paper down the toilet
(Chinese and possibly other cultures throw toilet paper into the trash can)
• Clarify what to do with feminine hygiene products to female delegates.
• Is there a hair dryer he/she may use?

Bedroom:
• Sleeping time and location
• Where to put their hanging and folded items
• What to do with dirty laundry
• How to turn on/off lights
• Is it okay to open the windows (many countries don’t use air conditioning)
• What to do if cold or hot

Laundry:
• Where is it
• Who does laundry
• When is it done
Technology:
• Which may be used
• How to turn on and offer
• No tagging of youth in pictures. Ask before posting.

Entering and exiting the home:
• Is it okay to leave a door and/or screen door open

Bikes/personal items:
• Which can be used
• Does the delegate need permission to use the device

Encourage your children or other family members to introduce their international guest to their friends but emphasize to be sure that the delegate is also included in conversations.
I have reviewed the list of topics to cover with the guest and will discuss these topics as appropriate.

I confirm
Acknowledgement of CISV Child Protection Policy

CISV believes that the welfare of children is the highest priority and that it is the responsibility of everyone in CISV to ensure they are protected. The child protection policy below sets out CISV's commitment to Child Protection and aims to promote good practices in (1) providing children with appropriate safety and protection while in the care of CISV and (2) allowing volunteer and staff to make informed and confident responses to specific Child Protection Issues.
The policy is available below. You can also access the policy here: https://cisv.org/resources/risk-management-safeguarding/child-protection/
I have read and will abide by the procedures about (1) adult communication with and about children (including online), (2) adults taking, using and storage of CISV images / videos, and (3) the taking, using and permission to use images / video and art or written work by children stated in the Child Protection Policy.

I confirm
I have read and will abide by the procedures for recognising, reporting, and documenting concerns related to child abuse stated in the Child Protection Policy.

I confirm
I have read and will abide by all other procedures stated in the Child Protection Policy.

I confirm
Acknowledgment of CISV Behavior Policy (R-07)

CISV International promotes an inclusive learning culture that furthers CISV’s mission to educate and inspire action for a more just and peaceful world.
This includes creating positive learning environments wherever we meet or work together, as well as promoting behaviours that are in line with our values.

Our educational approach helps children and adults gain the attitudes, skills, and knowledge that contribute to becoming active global citizens with lasting cross-cultural relationships. To do this we must establish shared standards and expectations that govern all our programmes and events. Though we recognize that behaviour norms may vary across our members’ cultures, everyone in CISV must follow the standards, expectations and rules set out in this policy.

In line with The Universal Declaration of Human Rights and the Convention on the Rights of the Child, we believe in actively promoting and creating an inclusive learning culture where all people have the right to feel safe and included.

Positive behaviours support the values of CISV:

Friendship - We find a common bond and we are kind to each other.

Inclusiveness - We are open, we accept and respect others.

Cooperation - We work together and support each other toward our common goal.

Enthusiasm - We bring energy and passion to everything we do.

Engagement - We show up, participate and learn with a positive attitude
CISV has adopted a policy about appropriate behaviors at CISV programs. The policy is below and is also accessible online at https://cisv.org/resources/risk-management-safeguarding/
I have read and will abide by CISV's Positive Behaviour Policy.

I confirm
Adult Code of Behaviour

This Code of Behaviour applies to all adults in CISV as well as to Children in roles of trust and responsibility, e.g. Junior Counselors and people in Junior Branch Leadership Positions. The Code applies at all levels and with all interactions that CISVers have, both in person and online. This Code helps CISV to provide a positive, inclusive and welcoming environment that reflects our values and where everyone feels safe, supported and respected.
I WILL ALWAYS:
✓ Put the safety and welfare of the children in CISV as my first priority.
✓ Help create a culture where children feel safe
✓ Encourage children to speak out and bring up any concerns they have.
✓ Listen to the voices of children
✓ Treat everyone with courtesy, dignity and respect.
✓ Recognize that as adults we are role models at all times and we set the tone for what is acceptable
✓ Model positive behaviours that reflect the values of CISV: Friendship, Inclusiveness, Enthusiasm, Engagement and Cooperation.
✓ Follow CISV rules, especially the Behaviour Policy and the Child Protection Policy (see especially Procedure 4: Communicating with and about Children).
✓ Recognize that my behaviour, both in person and online, affects the reputation of CISV ✓ Use appropriate language and behaviour in all forms of communication.
✓ Report all concerns about inappropriate or forbidden behaviours immediately to the Person in Charge.
✓ Avoid physical contact or displays of intimacy that could reasonably be perceived as inappropriate or an abuse of power or trust.
✓ Challenge others on behaviour that I feel is against our Code of Behaviour and be open to be challenged by others on my behaviour.
I understand and agree to follow this Code of Behaviour at all times. I understand that violating this Code may result in serious consequences including temporary or permanent removal from an activity or a programme, and / or suspension or termination of my CISV membership.
I have read the Adult Code of Behaviour and will abide by it.

I confirm
Child Code of Behaviour

This Code of Behaviour applies to every child in CISV. It applies at all activities – both in-person and online. This Code helps CISV to provide a positive, inclusive and welcoming environment that reflects our values and where everyone feels safe, supported and respected. This code should be shared and discussed at the beginning of any CISV activity or event.
This Code of Behaviour applies to every child in CISV. It applies at all activities – both in-person and online. This Code helps CISV to provide a positive, inclusive and welcoming environment that reflects our values and where everyone feels safe, supported and respected. This code should be
shared and discussed at the beginning of any CISV activity or event.

As a child in CISV, I WILL:
✓ Be friendly, polite and helpful toward others.
✓ Respect everyone regardless of things like age, gender, sex, sexual Orientation, ability, race, cultural background or religious beliefs.
✓ Respect the boundaries, privacy and property of others.
✓ Keep myself safe.
✓ Challenge and report the bullying or inappropriate behaviour of others.
✓ Contribute to a creating a safe space for everyone
✓ Be a good role model
✓ Openly share my opinions, needs and concerns
✓ Encourage others to share their ideas.
✓ Follow the rules.

I have the right to
✓ Be and feel safe
✓ Be listened to
✓ Be respected and treated fairly
✓ Be protected from abuse by other member or outside sources
✓ Participate on an equal basis, appropriate to my ability
✓ Be believed.
✓ Ask for and get help

I WILL NOT:
✓ Pick on or make fun of others
✓ Bully others
✓ Get involved in peer pressure or push others into something they do not want to do.
✓ Be mean
✓ Break the law
I understand that CISV programmes and activities are not the place for sexual behaviours or relationships.

I understand and agree to follow this Code of Behaviour.
I understand that if I don’t follow this Code, there may be serious consequences: I may have to leave the CISV activity or programme and I might lose my CISV membership temporarily or forever.
I have reviewed this Child Code of Behaviour with all children in my home that will be living or interacting with CISV participants during the home stay and they have agreed to abide by it.

I confirm
Adult #1 in the Home: Please sign to acknowledge and agree that (1) the information in this form is accurately completed and (2) you have read and will abide by the CISV Child Protection Policy, the Positive Behaviour Policy, and the CISV Adult Code of Behavior and (3) each child in the home interacting with CISV participants will comply with the Child Code of Behaviour. (Each adult in the home should sign). *

Clear
Adult #2 in the Home: Please sign to acknowledge and agree that (1) the information in this form is accurately completed and (2) you have read and will abide by the CISV Child Protection Policy, the Positive Behaviour Policy, and the CISV Adult Code of Behavior and (3) each child in the home interacting with CISV participants will comply with the Child Code of Behaviour. (Each adult in the home should sign).

Clear
Name of Adult #2 Signing Above

First NameLast Name
Adult #3 in the Home: Please sign to acknowledge and agree that (1) the information in this form is accurately completed and (2) you have read and will abide by the CISV Child Protection Policy, the Positive Behaviour Policy, and the CISV Adult Code of Behavior and (3) each child in the home interacting with CISV participants will comply with the Child Code of Behaviour. (Each adult in the home should sign).

Clear
Name of Adult #3 Signing Above

First NameLast Name
Date of Signatures

MonthDayYear
Date
Should be Empty:

HOST FAMILY AGREEMENT & ORIENTATION

CISV Homestay Goals

Restrictions on Certain Activities While Hosting

Host Family Orientation

How to make the people you are hosting feel welcome

Acknowledgement of CISV Child Protection Policy

Acknowledgment of CISV Behavior Policy (R-07)

Adult Code of Behaviour

Child Code of Behaviour