Future for KIDS - Mentor Application

Personal Information






Address Information









I am Interested in being involved in the following ways:







Reference Information
Please provide three references that are able to discuss your character: 












Emergency Contact Information
Please provide an emergency contact:



VOLUNTEER WAIVER

By typing my name below and in acceptance of this entry, I hereby, for myself, my heirs, my executors and administrators, waive any and all rights and claims for damages or injunctive relief I may have against Future For KIDS, the partner location where the program, camp or event is held, and its sponsors, contractors, volunteers, coordinating groups, and any individuals associated with this event, their representatives, successors and assigns, and will hold them harmless for any and all injuries suffered in connection with this event. Also, none of the above are responsible for the loss of personal items nor any other form of inconvenience or aggravation in connection with this event. I have been warned that I must be in good health to participate in any sporting event and physical exertion or outdoor elements need to be considered when signing up to volunteer. I attest to the truthfulness of all information listed on this application. In the event that I am chosen to be a volunteer with youth, I agree to the commitment and to participate to the best of my ability. I will honor confidential information regarding the children I work with. I will be free of the influence of alcohol or illegal drugs when volunteering. I understand that Future for KIDS has a “no contact” policy when working with the youth. I understand that I am not to be alone with youth participants, and I will only use designated adult or staff restrooms while on the site premises. I understand there is no outside contact with the youth participants and I am to leave the site premises immediately after the program has ended each day.


I also acknowledge that I am an amateur in events of this nature. I hereby agree that photographs and video can be taken and published for purposes of marketing, program promotion, and funding.


Captcha

Please enter the characters you see in this picture:

Visual CAPTCHA

This helps prevent automated form submissions. If you are not sure what the characters are, make your best guess. You will have another try in the next screen.
Can't see the image? Click here for an audible version in English.

Need assistance with this form?