JCCYC Disaster Relief Volunteer Registration Form

Full Legal Name

First NameLast Name

Lived/Preferred Name (if different from above)

First NameLast Name

Email Address

example@example.com

Date of Birth

Date

Gender Identity

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Please select which parish(es) you are based in

Name of community you live in (please indicate for which parish if you selected more than one parish above)

Do you have EMS,CPR or any other certification that may be helpful to disaster relief? If yes, please state same.

How do you think you'll be able to assist? Select all that applies

Are there any other area(s) not listed above where you'll be able to provide support?

Are you physically able to perform any kind of manual labor?

Do you own or have access to a vehicle and are you able to drive?

What is your availability?

Rows	Weekdays (Mon-Friday)	Weekends (Sat & Sun)
AM
PM

Do you have any medical conditions or allergies we should be aware of? If yes, please state same.

Emergency Contact Name

First NameLast Name

Emergency Contact Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Disaster Relief Volunteer Agreement & Liability Waiver

I hereby release the Jamaica Climate Change Youth Council (JCCYC) its officers, members, and contractors from any and all claims arising from personal injury, property damage, or loss, including damage to vehicles, that may occur during participation in disaster relief efforts.

I understand that volunteering in disaster response involves inherent risks, and I voluntarily accept full responsibility for any such risks.

I understand that this is a volunteer position and not a contract of employment. As a JCCYC volunteer, I will not accept payment for services or gifts from third parties in connection with these efforts.

I understand that I am responsible for any incidental costs I may incur while volunteering, such as meals and transportation, unless otherwise stated.

I am willing to provide copies of any applicable licenses or certifications for verification purposes by JCCYC.

I agree to:

Treat all individuals with respect and dignity.
Follow the directions of team leaders and executive members.
Maintain confidentiality regarding any personal information learned during relief efforts.
Avoid discrimination, harassment, or unsafe/bad behaviour of any kind.
Use equipment and materials responsibly and only for their intended purpose.
Immediately report any unsafe conditions, misconduct, or concerns to the team leader or organization’s executive team.

I agree not to take photographs or videos of relief efforts, affected individuals, or personal property without the explicit permission of the residents or those involved.

I affirm that I am at least 18 years of age and legally able to enter into this agreement.

If I am under 18 years of age, this form will be signed by my parent or legal guardian, who grants permission for my participation and accepts the terms on my behalf.

By typing my name below, I acknowledge that I have read, understood, and agree to the terms outlined in this waiver.

Please select who is completing this form

Parent or Legal Guardian Full Legal Name

By typing my name I hereby agree to the Volunteer Agreement & Liability Waiver on behalf of my child/ward.

Full Legal Name

By typing my name I hereby agree to the Volunteer Agreement & Liability Waiver

Date