Volunteer & Intern Agreement Form

1
Email* This field is required.Please provide a reliable email address you can be contacted through.
example@example.com
2
Name * This field is required.
She
She
He
Them
Pronouns
First Name
Last Name
3
Are you Volunteering or an Intern?* This field is required.
Please Select
Please Select
Intern
Volunteer
Intern & Volunteer
4
Contact Number* This field is required.Phone number where you can be called/texted
Area Code
Phone Number
5
Emergency Contact Name & Phone Number?* This field is required.
6
Shirt size - unisex shirts with a regular crew neck* This field is required.* (if you plan on volunteering up until the dates of both conferences please select a shirt size, otherwise select ‘not applicable’). Dates: April, 12th & 13th of 2025.
XS
SM
M
L
XL
2X
I don't plan on Volunteering during KBMHC & Fatherhood Summitt
7
Do you have any health or physical limitations that will not allow you to stand or sit for as long as an hour, lift/push/pull/carry as much as 40 pounds? If so, please tell us more below so we can accommodate your needs. If not, please move on to the next question.
8
Have you downloaded the telegram app that we will be using for planning and days of conference, including group/direct messaging to Volunteers or Intern?* This field is required.
Yes- Telegram is locked and loaded!
No- but I'm going to do it right now! Thanks for the reminder.
9
# of hours/days you can Volunteer or Intern? * This field is required.Please list your hours and days you can dedicate your time in planning or volunteering for KBMHC.
10
Volunteer agrees to the following terms and conditions:

Volunteer agrees to be present and punctual (on time) for all assigned shifts while at KBMH Conference & Fatherhood Summit performing services voluntarily for KBMHC or be subject to reimbursement to KBMH via Community Shares of Tennessee for applicable travel registration, swag and accommodation expenses.

Volunteer agrees that she/he/they are volunteering solely for personal, civil, charitable or humanitarian purposes without promise or expectation of compensation, benefits or future employment from KBMHC.

Volunteer will perform services under the direction of KBMH Staff during the 2025 conferences and all related events.

Volunteer will assist with assignments and duties such as event staffing, ushering event patrons and attendees throughout the event spaces, and distributing KBMHC merchandise, products, and literature, securing or retrieving items for KBMHC staff, as well as providing directions to navigate an event space. Some set-up and breakdown duties may be required.

Volunteer acknowledges that she/he/they are not an employee of KBMHC, and is not entitled to receive salary, benefits or other compensation beyond that agreed upon such as flight and hotel accommodations. Volunteer further acknowledges 100% of all funds raised by him/her/them while volunteering for KBMHC will go to KBMHC as a nonprofit organization.

Volunteer understands that she/he/they does not qualify for worker’s compensation benefits and are expected to carry personal medical insurance to cover medical expenses for any injury s/he/they may incur while performing services voluntarily for KBMHC.

The parties agree that this is the entire Agreement between them and that no other Agreement, either oral or written, exists outside of this Agreement regarding the volunteer services described above.

Volunteer hereby grants full permission to KBMHC to use their name and likeness in all forms in any and all media including but not limited to publications, brochures, books, magazines, photo exhibits, video, and/or other media or commercial, informational, educational, advertising, or promotional materials without compensation.

Volunteer agrees that they will not use the name and likeness (photo, video, voice recording and/or any and all forms) of any client or patron of KBMHC (moms, kids, babies, influencers, performers) in any and all forms of media, including but not limited to social media unless they have written or verbal consent from client/patron.

Volunteer releases KBMHC, its affiliates, members, predecessors, successors, assigns, agents, independent contractors, directors, officers, representatives, attorneys, insurers, and all persons acting by, through, under or in concert with any of them (collectively “Releasees”) from any responsibility or liability for injuries to Volunteer, including without limitation, personal injury, death, and/or damage to or loss of property, arising out of the known and unknown risks associated with these volunteer activities, the non-profit’s negligence, and/or accidental occurrences while visiting or otherwise engaging in activities before, during, or after KBMHC 2025 events.
11
Date of Service* This field is required.Filling out the form will begin your internship or volunteer service.
Date
Year
Month
Day
12
Signature* This field is required.In witness thereof, party named below enters this agreement as of date in next section. Please enter Volunteer Name (and Parent or guardian's name if volunteer is under 18 years old):
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