Youth Volunteer Application

Required Volunteer Information

Thank you for your interest in volunteering with Ceres Community Project! In order to volunteer, you must meet the following qualifications:

Be at least 14 years of age and in 8th grade or higher.
Agree to volunteer least 2.5 to 3 hours per week for 12 consecutive weeks.

If you are 18 or older, you can use this application or you can also feel free to use our online adult application.

About This Application

Page 1 requests required information about the youth volunteer.
Page 2 requests information about the volunteer's parent or guardian, and collects medical information in case of emergency.
Page 3 is a liability release that should be read and confirmed by the parent or guardian.
Page 4 is a media release that should be read and confirmed by the parent or guardian.
At the end of the form, we will request an e-signature. If you are under 18 years of age, the e-signature should be completed by your parent or guardian.

Youth Contact Information

First Name

Last Name

Mobile Phone

Home Phone

Preferred Phone

Email

Birthdate

From time to time, we might want to send you text about your upcoming shifts, or about other opportunities and events with Ceres. Do you want to receive texts from us? Some things for you to know:

Standard message rates apply.
You can expect to receive 1-5 texts per month.
This will allow us to text you updates and reminders about your shift, as well as keep you in the loop about upcoming volunteer events and opportunities.
You can always opt out by texting STOP back to us.

Opt In - Send Me TextsOpt Out - Please Don't Text Me

Address

Mailing Street

Mailing City

Mailing State

We only work with volunteers in California at this time.

Mailing Zip/Postal Code

County

Demographic Info

This information is confidential. Our funders are interested in knowing the demographics of our volunteers. Participation is optional and will be used to describe our volunteers as a group and not individually. Thank you for your assistance.

Gender

Pronoun

We want to know what to call you. For example, she/her, he/him, they/them.

Youth Contract with Ceres Community Project

I agree to participate in all aspects of the kitchen and garden work and be willing to do

what is needed.

I agree.

I agree to participate fully, work as a team and be open, friendly and inclusive of others while at Ceres.

I agree.

I understand that Ceres is counting on me and that I am integral to accomplishing the work.

I agree.

I will let Ceres know when I am not able to show up.

I agree.

I agree to not share personal information about the clients.

I agree.

How did you hear about Ceres?

Please provide additional description, such as newspaper publication (Press Democrat, Marin IJ, etc) social media source (Twitter, Instagram, Facebook, etc), school or agency name. Thank you!

Parent Info and Emergency Medical Release

This information is required for participation in Ceres Community Project. Please complete each section thoroughly. We will ask for your signature at the end of the application.

Parent/Guardian #1 (Will receive youth's schedule)

First Name

Last Name

Mobile Phone

Home Phone

Work Phone

Email

Is your address the same as the youth volunteer's?

YesNo

New Address

Mailing Street

Mailing City

Mailing State

We only work with volunteers in California at this time.

Mailing Zip/Postal Code

County

Same Address

Mailing Street

Mailing City

Mailing State

We only work with volunteers in California at this time.

Mailing Zip/Postal Code

County

Parent/Guardian #2 Contact Info

First Name

Last Name

Mobile Phone

Home Phone

Work Phone

Email

Is your address the same as the youth volunteer's?

YesNo

New Address

Mailing Street

Mailing City

Mailing State

We only work with volunteers in California at this time.

Mailing Zip/Postal Code

County

Same Address

Mailing Street

Mailing City

Mailing State

We only work with volunteers in California at this time.

Mailing Zip/Postal Code

County

Allergies: Does this youth have any allergies to food?

We just want to know if we need to alert you when handling or preparing certain food items.

Please indicate any other allergies not on the list above (i.e. other foods, insects, medications, etc.)

Health conditions: Does this youth currently or in the past have any medical conditions that we may need to know about that would impact their work in the kitchen, or in case they need treatment? I.e. does this youth need to carry an EpiPen with them? If so, please explain.

Please list any medications currently taken by this youth.

Youth's Physician and Alternate Emergency Contact

Name of Youth's Physician

Physician's Phone

Alternate Emergency Contact (In case we cannot reach parent/guardian)

Alternate Emergency Contact Phone Number (mobile preferred)

Alternate's Relationship to Youth

In case of emergency, take this youth to the following hospital (please check one)

Nearest hospitalA specific hospital

Name of hospital:

If, in the judgment of the staff of the Ceres Community Project, the youth named above needs immediate care and treatment as a result of any injury or sickness, I hereby give permission to the staff to secure proper treatment for this youth. I do hereby consent to whatever x-ray, examination, anesthetic, medical, surgical, or dental diagnosis or treatment and hospital care are considered necessary in the best judgment of the attending physician, surgeon, or dentist and performed by or under the supervision of the medical staff of the hospital or facility furnishing medical or dental services. It is further understood that the undersigned will assume full responsibility for any such action, including payment of costs. I do hereby agree to indemnify and hold harmless the Ceres Community Project (including its officers, directors, staff members, and/or volunteers) from any claim by any person whomsoever on account of such care and treatment of said youth.

I agree.

Release From Liability

1. I agree to work for Ceres Community Project as a volunteer.

2. As a volunteer, I understand that I control the dates and times when I do the work and that Ceres Community Project is not responsible for scheduling my volunteer work. I also understand that I will not be compensated for any time spent volunteering, nor am I entitled to benefits, including employment insurance benefits upon the termination of this agreement or as a result of this service.

3. I am aware that participation as a volunteer may require periods of standing, lifting and carrying objects up to 40 pounds, and will require the exercise of reasonable care to avoid injury. I am voluntarily participating in this activity with knowledge of the hazards and potential dangers involved, and agree to accept any and all risks of personal injury and property damage.

4. As consideration for volunteering for Ceres Community Project, I hereby agree that I, and my assignees, heirs, guardians, and legal representatives, will not make a claim against or sue Ceres Community Project or its employees, agents, or contractors for injury damage resulting from the negligence, whether active or passive, or other acts, however caused by any of its officers, employees, agents, or contractors of Ceres Community Project as a result of my volunteering. I HEREBY RELEASE AND DISCHARGE Ceres Community Project AND ITS OFFICERS, EMPLOYEES, AGENTS AND CONTRACTORS FROM ALL ACTIONS, CLAIMS, OR DEMANDS THAT I, MY HEIRS, GUARDIANS, AND LEGAL REPRESENTATIVES NOW HAVE, OR MAY HAVE IN THE FUTURE, FOR INJURY OR DAMAGE RESULTING FROM MY PARTICIPATION IN THE PROJECT.

5. I UNDERSTAND THAT IF I AM INJURED IN THE COURSE OF THE PROJECT, I AM NOT COVERED BY Ceres Community Project’s WORKER’S COMPENSATION PROGRAM. I authorize Ceres Community Project to seek emergency medical treatment on my behalf in case of injury, accident, or illness to me arising from my involvement as a volunteer. I understand that I will be responsible for medical costs incurred by such accident, illness or injury.

6. I understand that the materials and tools provided by Ceres Community Project are and remain the property of Ceres Community project, and I agree to return these tools and any remaining materials to Ceres Community Project at the end of my volunteer service.

7. I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND IT’S CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY, AND SIGN IT OF MY OWN FREE WILL. (If the youth volunteer is under 18 years of age, a parent or guardian must read the release. This release, it's significance, and assumption of risk have been explained to and are understood by the minor.)

I agree.

Media Release

As a non-profit social benefit organization Ceres Community Project depends on donations from individuals, businesses, organizations and foundations to support our work. Sharing stories about our programs and their impact is vital to our ability to raise funds. We ask for your partnership in this effort by signing the photo release.

Video, Photographic, Internet Release Agreement

The undersigned enters into this agreement with Ceres Community Project. I have been informed and understand that Ceres Community project may wish to use my own and/or my child’s first name, likeness, and speech in its printed and/or electronic communication materials (brochures, videos, website, social media, etc.)

I grant Ceres Community Project and its designees the right to use such images and information. This grant includes the right to edit, mix, or duplicate and to use or re-use the images in whole or in part and in any manner as Ceres Community Project in its sole discretion may elect. Ceres Community Project or it’s designee shall have complete ownership of the images and any printed material, video programs, web content (i.e. material accessible over the internet) in which the images may appear.

I also grant the right to broadcast, exhibit, and otherwise distribute images as well as printed materials, video programs and/or web content in either whole or in part, and either alone or with other products.

I confirm that I have the right to enter into this agreement; that I am not restricted by any other commitments to third parties; and that Ceres Community Project has no financial commitment or obligations to me as a result of this agreement.

I hereby give clearances, copyright and otherwise, for the use of such images, and I expressly release Ceres Community Project and its officers, employees, agents and designees from any and all claims known or unknown arising in any way connected with the above uses and representations. The rights granted Ceres Community Project herein are perpetual. I hereby acknowledge receipt of reasonable and fair consideration.

Edit this text

I agree with the above.No. I do not grant Ceres the right to use my child's name, photo, or words.

This release will supersede any previous releases on file.

Please click "Submit" to review your answers and sign the form. Once you have signed the form, please do not close the window until you receive a confirmation message--it can take a few seconds to process your responses.