Volunteer One-Event Form

Volunteer One-Event Form
Thank you for choosing to volunteer with Boys & Girls Clubs of Metro Los Angeles (BGCMLA)!

Please complete and submit the form below prior to volunteering onsite at our Clubhouses.

During this time, we are accepting a maximum of 10 volunteers per site.

We do NOT accept volunteers under the age of 18.
About You
Name*

First NameLast Name
Mailing Address

Street Address

Street Address Line 2

CityState

Zip Code
Email*
example@example.com
Cell Phone Number *
Please enter a valid mobile phone number.
Company / Organization Representing
Which company or organization are you representing? If none, leave blank.
I am 18+ years old.*

YesNo
I give Boys & Girls Clubs of Metro Los Angeles permission to contact me with general or volunteer information.*

YesNo
Emergency Contact Information

In case of an emergency, please identify your emergency contact below.
Emergency Contact's First Name *
Emergency Contact's Relationship to You*
Emergency Contact's Phone Number *
Please enter a valid phone number.

Liability Waiver & Release
Please read and sign below.
- I understand my involvement in activities with the Boys & Girls Clubs of Metro Los Angeles (BGCMLA) and its partner agencies is voluntary and I will receive no compensation or remuneration from the Club for the work that I will perform.
- I understand that this release is for a one-time event and I will contact the Development Ops. Coordinator if I wish to volunteer again.
- I understand that volunteering may involve the use of tools, working inside or outside buildings, working in a variety of weather conditions, standing and walking on uneven terrain, performing work that may be repetitive, or require lifting, sitting, stooping and/or stretching.
- In connection with my (or my child’s) voluntary involvement in activities undertake for and with the participation and support of the BGCMLA, a non-profit charitable organization, I hereby agree for myself, my heirs, assigns, executors and administrators to release and discharge the BGCMLA, its officers and directors, employees, agents, all partner agencies, and volunteers from all claims, demands and actions for injuries sustained to my person and/or property as a result of my involvement in such activities.
- I agree to release and hold the BGCMLA, its officers and directors, employees, agents, all partner agencies, and volunteers harmless from any cause or action, claim or suit arising there from.
- I hereby attest that my (or my child’s) attendance and involvement in such activities is voluntary, that I am participating at my own (or my child’s) risk, and that I have read the foregoing terms and conditions or this release.
- I agree to the use of my (or my child’s) photograph for the publicity and public relations of the BGCMLA, and its partner agencies.
- I hereby confirm, represent and warrant that I have never been convicted or charged with a violent crime, child abuse, or neglect, child pornography, child abduction, kidnapping, rape or any sexual offense, nor have I been ordered by a court to receive psychiatric or psychological treatment in connection therewith.
- I agree to never hug or touch youth, allows them to sit on my lap, hold hands, etc.
- I agree that I will not take pictures of the BGCMLA members without written consent from the BGCMLA.
- I agree to not enclose myself in a room alone with any BGCMLA member or allow the BGCMLA member in my vehicle.
- I also agree to abstain from outside interaction with BGCMLA members outside of BGCMLA property and/or BGCMLA hours.
Signature*

Clear
Event Date*

MonthDayYear
Location*
Should be Empty:

Volunteer One-Event Form

About You

Emergency Contact Information

Liability Waiver & Release

Please read and sign below.