Boys & Girls Clubs of Laurens & Johnson Counties will survey and interview our children to find out what his/her behaviors, skills and attitudes are in regard to issues such as health risks and habits, positive self-esteem, respect for diversity, education and educational resources, positive relationships, career choices, and connection to community, as well as his/her experiences at the BGCLJ. The purpose of these surveys and interviews is to help find out how well the Boys & Girls Clubs are meeting your child’s needs to identify areas which may call for further attention. I also understand that this information will remain private, and that only the management staff and assigned research assistants representing the Boys & Girls Clubs organization will be able to look at his/her responses. I understand that my child’s responses will be automatically grouped together with the responses of other Boys & Girls Club members for any public presentation of the findings, and that my child will never be individually linked to his/her responses.

Option 1: I give BGCLJ permission to survey and interview my child with respect to the above mentioned.

Option 2: I DO NOT give BGCLJ permission to survey and interview my child with respect to the above mentioned.