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BOYS AND GIRLS CLUB OF SOUTHWEST MISSOURI

Volunteer Application

317 Comingo Ave, Joplin MO 64801

417-623-80725700 Fax: 417-781-3825

GENERAL

Previous or Present Volunteer Jobs

Most Recent

Previous or Present Volunteer Jobs

Next Most Recent

Previous or Present Volunteer Jobs

Next Most Recent

Skills and Interests

Is there a paticular type of volunteer work in which you are interested? (Check all that apply)

Are there any groups you would not feel comfortable working with?

Availability

At what times are you interested in volunteering?

How did you hear about us?

References

Give names and addresses of 3 persons (not relatives) having knowledge of your character, experience, and ability

Reference One

Reference Two

Reference Three

CONSENT FORM

I hereby authorize Boys & Girls Club of Southwest Missouri to receive any criminal history record information pertaining to me which may be in the files or any state of local criminal justice agencies.

The undersigned, in consideration of participation of this program, agrees to indemnify, hold harmless, and release the Boys & Girls Club of Southwest Missouri, it’s members, employees, officers, directors, agents, and associated personnel, whether paid of volunteer against all claims, demands, and causes of action related to injury, disability, death, or any other loss or harm to person or property resulting from my child’s participation in this program, whether arising from the negligence of the releases or otherwise, to the fullest extent permitted by law. I have read the agreement and fully understand that I assume all risks for any injuries received.

TALENT RELEASE

I understand that photographs or videotapes may be made of my volunteer activities at Boys & Girls Club of Southwest Missouri. I authorize the Boys & Girls Club of Southwest Missouri, without limitation, to copy, publish, or distribute such photographs or videotapes for the purpose of reporting or promotion of volunteerism. I waive all rights and claims I may have against your organization, and/or its agents, subsidiaries, or assignees related to the above photos and videotapes.

Dear Prospective Volunteer:
Thank you for your interest in volunteering with the Boys & Girls Club of Southwest Missouri. With your help, we can strengthen existing programs, add new programs, and extend them to more boys and girls. Our emphasis is on providing wholesome activities supervised by adults of high moral character. Because the risk, no matter how remote, of exploitation or abuse of our boy and girls club members is unacceptable, we are required to secure your consent for a background check and examine all references. Thank you for your understanding of both the need and the time (approximately 2 weeks) it will take to process your placement.