Jr. Volunteer Application Form (If you are 18 or older, please contact volunteers@cayu.ca to get the correct volunteer application form)

General Information

Name

Birthdate must be written in DD-MM-YYYY form

Birthdate

Sex

Male Female

Phone

This address will receive a confirmation email

Address

Primary Community

Central Organization Lacombe Maskwacis Ponoka Red Deer Rimbey Sylvan Lake Blackfalds Three Hills

Name of CAYU staff member or program you have connected with regarding volunteering (if applicable).

Profile Picture

Upload (8MB)

Medical Information (This information will be used only in emergency situations once your volunteer application is accepted. It is not used to determine your eligibility to volunteer.)

Allergies (and Severity)

Medical Concerns, Life Threatening Conditions and emergency treatment, any other health concerns you would like us to be aware of.

Alberta Health Care #:

Parent/ Guardian Contact

Parent/ Guardian Name

Parent/ Guardian Phone Number

Parent/ Guardian Email

Parent/ Guardian Relationship to you

Emergency Contact (In case Parent/ Guardian Listed above cannot be contacted)

Contact 1 Name

Contact 1 Phone Number

Contact 1 Email

Contact 1 Relationship to You

Experience

Do you have any volunteer experience?

Yes No

If yes, please provide information regarding this experience.

Other areas/ programs of interest:

Hobbies and Interests

Please specify or add anything else you find enjoyment in.

Special Skill/ Training

Please describe any special skills you possess or any specific training you may have.

Do you have experience working with youth?

Yes No

If yes, please describe your experience.

EDUCATION

What school are you currently attending?

Year of Study or Grade:

Other Information

Name of Church, if attending:

Who is Jesus to you?

Why do you desire to be a part of the CAYU Volunteer Team?

References (Please provide 2 references, preferably one being a pastoral reference). Note: references should not include family members, and should be adults. Teachers, coaches, and family friends are all great people to ask if you aren't sure where to start.

1. Name:

1. Relationship to you:

1: Phone Number:

1: Email Address:

2. Name:

2: Relationship to you:

2: Phone Number:

2: Email Address:

The Legal Stuff... Please get your Parent/ Guardian to help you- they will need to sign some of the sections below and can help make sure you understand the Conduct Agreement and Faith Agreement.

Conduct Agreement

As a volunteer with Central Alberta Youth Unlimited (Please check of each area as a sign of your agreement):

I agree to hold personal information I learn about others in confidence. I will not share that information except with CAYU staff. I will never put myself in a position where I am alone with someone who is underage, and will make sure that there is always another staff member or volunteer who can see me when I'm with a CAYU program participant I will treat all of the people I volunteer with and serve with kindness and respect If I do not feel comfortable with something, I will talk to my supervisor so that they can help me. I don't have to do anything I am not sure about or feel uncomfortable with If I am working with children or toddlers, I will not help them with toileting or diaper changing. I understand that only adult volunteers can do this job. If I see, hear, or am worried that someone might be at risk of being abused, hurting themselves, or hurting others, I will tell my supervisor or another adult volunteer right away.

Faith Agreement

CAYU is a non-denominational Christian faith centered organization that operates to foster hope and wholeness in all youth. As a volunteer, I will do my best to live out the love, hope, compassion and kindness of Jesus to all of the people I interact with in the areas I am volunteering in.

Yes No

Below, you will find the tenets which make up Central Alberta Youth Unlimited's Statement of Faith. If you/ your child have an understanding of these tenets, you are welcome to respond to the tentets, however it is not a requirement of Jr. Volunteers.

We believe the Bible to be the inspired and only infallible authoritative Word of God. Yes No No, however while volunteering with and/or representing CAYU/ YFC, I will not conduct myself in a manner contradictory to this belief.

We believe that there is one God eternally existent in three persons: Father, Son and the Holy Spirit. Yes No No, however while volunteering with and/or representing CAYU/ YFC, I will not conduct myself in a manner contradictory to this belief.

We believe in the deity of our Lord Jesus Christ, in His virgin birth, in His sinless life, in His miracles, in His vicarious and atoning death through His shed blood, in His bodily resurrection, in His ascension to the right hand of the Father, and in His personal return in power and glory. Yes No No, however while volunteering with and/or representing CAYU/ YFC, I will not conduct myself in a manner contradictory to this belief.

We believe that for the salvation of lost and sinful man, regeneration by the Holy Spirit is absolutely essential. Yes No No, however while volunteering with and/or representing CAYU/ YFC, I will not conduct myself in a manner contradictory to this belief.

We believe in the present ministry of the Holy Spirit by whose indwelling the Christian is enabled to live a godly life. Yes No No, however while volunteering with and/or representing CAYU/ YFC, I will not conduct myself in a manner contradictory to this belief.

We believe in the resurrection of both the saved and the lost; that they are saved unto the resurrection of life and they that are lost unto the resurrection of damnation. Yes No No, however while volunteering with and/or representing CAYU/ YFC, I will not conduct myself in a manner contradictory to this belief.

We believe in the spiritual unity of believers in Christ. Yes No No, however while volunteering with and/or representing CAYU/ YFC, I will not conduct myself in a manner contradictory to this belief.

This electronic signature indicates my belief in tenets as indicated above.

FOIPP Consent Form

Under the Freedom of Information and Protection of Privacy act, I grant CAYU/ YFC permission to use the following (please check all that apply) for the purposes of media content, promotion, and contacting purposes as appropriate.

All permissions listed below Video Photo Name Sharing Contact Info with volunteers for contact related to programs No Permission Granted

FOIP Waiver Acceptance Signature (Must be signed by parent/ guardian if under 18)

CAYU Program Participation & Driving Waiver

1. The risk of injury from youth activities and equipment involved in some Youth Unlimited programs is significant, including the potential for permanent disability and death, and although personal discipline will minimize the risk, the risk of serious injury does exist;

2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE of those persons released from liability below, and assume full responsibility for my child/ren's participation;

3. I, for my child/ren, and on behalf of my heirs, assigns, personal representatives and next of kin, hereby release and hold harmless Youth Unlimited Central Alberta, the owners and leasers of premises used to conduct the activities and programs, their directors, officers, officials, agents and/or employees ("Releasees"), with respect to any and all injury, disability, death or loss or damage to person or property whether caused by the negligence of the Releasees or otherwise, except that which is the result of gross negligence and/ or wanton misconduct.

4. I, the undersigned parent/ legal guardian, will not hold CAYU responsible for any personal injury, or care provided, or for any loss or damage whatsoever with respect to my child/ren. I waive any claim against CAYU, its employees, agents and board members and release them from all liability. I further indemnify the for all losses they might suffer.

5. In the event of injury or illness, I authorize CAYU staff to seek and obtain medical or surgical attention for my child/ren named above in the event of an emergency, without the necessity of prior approval. It is understood that if any emergency occurs, a responsible adult will ensure that my child/ren receives proper medical attention and that arrangements are made for his/ her return home, if necessary. I understand that I will be notified by the quickest possible means if this authority is exercised.

6. I, the undersigned parent/ legal guardian authorize my child/ child under my guardianship, (named above) to drive with a CAYU staff member or Volunteer who has satisfactorily completed all screening protocol as per CAYU's policies to and/or from any and all activities related to the programming of Central Alberta Youth Unlimited / YFC for which I have authorized permission to attend below.

In signing the release, I (we) understand the intent thereof, and I (we) hereby agree and absolve and hold harmless the Association of Central Alberta Youth For Christ, and any other parties connected with the CAYU programs in any way, singly or collectively from and against any blame and liability for any injury, misadventure, harm , loss, inconvenience or damage hereby suffered or sustained as a result of participation in the event, or any activities associated therewith. I (we) hereby consent to and permit emergency treatment in the event of injury or illness. I confirm that the information I have provided is correct.

Please check off all programs you grant permission for your child/ren to participate in:

All Central Alberta Youth Unlimited events and programs my child is eligible to participate in. *Note, Trips and events beyond our regular program will require additional permissions prior to a child/ youth's attendance. Volunteering with Central Alberta Youth Unlimited

I CONFIRM THAT I HAVE READ AND UNDERSTOOD THIS RELEASE AGREEMENT PRIOR TO SIGNING IT, AND I AM AWARE THAT BY SIGNING THIS RELEASE AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I OR MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATIONS, ASSIGNS AND REPRESENTATIVES MAY HAVE AGAINST THE RELEASEES. BY SIGNING, I AM AGREEING THAT MY CHILD MAY PARTICIPATE IN THE PROGRAMS I HAVE INDICATED ABOVE, AND THAT MY CHILD MAY BE DRIVEN MY APPROPRIATELY VETTED STAFF AND VOLUNTEERS AS PART OF THOSE PROGRAMS.

Yes No

Name of Person This Release is being signed for:

Electronic Signature of Acceptance of Program Participation and Driving Waiver (Must be signed by Parent/ Guardian if Participant is under 18)

Jr. Volunteer Application Form (If you are 18 or older, please contact volunteers@cayu.ca to get the correct volunteer application form)

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