Village Volunteer Program

Village Volunteer Program

Supporting Families. Building Community. Creating Safe Beginnings. For volunteers supporting Mama Kawsay Birthing & Wellness Co. and Elijah's Open Arms Foundation.
Thank you for your interest in volunteering with Mama Kawsay Birthing & Wellness Co. and Elijah's Open Arms Foundation.

Our volunteers are an important part of the village that supports mothers, babies, children, and families throughout our community. Whether you are assisting at events, organizing donations, supporting community outreach, helping with administrative tasks, or serving families directly, your time and dedication make a meaningful difference.

We are grateful for your willingness to serve and look forward to working alongside you.

With Appreciation,

Celia Spears
Founder, Mama Kawsay Birthing & Wellness Co.
President, Elijah's Open Arms Foundation
MISSION STATEMENTS

Mama Kawsay Birthing & Wellness Co.

Our mission is to empower, educate, and support families throughout pregnancy, birth, and postpartum by providing compassionate, evidence-based, culturally responsive care and community support.

Elijah's Open Arms Foundation

Our mission is to provide safe beginnings and restore hope for mothers and their children through community support, resource connections, and programs that strengthen families during times of need.
Volunteer Information
Full Name

First NameMiddle NameLast Name
Date of Birth

MonthDayYear
Date
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Occupation
Languages Spoken
Emergency Contact Name
Emergency Contact Relationship
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Volunteer Interest and Placement
Community Support
Events and Fundraising
Administrative Support
Family Support
Special Skills or Certifications
Availability
Willing to Complete a Background Check?
Would Like Future Volunteer Notifications?
Volunteer Acknowledgments
VOLUNTEER CODE OF CONDUCT
Our Village Commitment

As a volunteer, I commit to:

• Treat every individual with kindness, dignity, compassion, and respect.

• Maintain professionalism while representing the organizations.

• Respect confidentiality and privacy at all times.

• Support a safe, welcoming, and inclusive environment.

• Follow instructions provided by staff and leadership.

• Communicate promptly regarding schedule changes or concerns.

• Refrain from discrimination, harassment, bullying, or inappropriate behavior.

• Respect professional boundaries with clients, families, volunteers, and staff.

• Serve as a positive ambassador for Mama Kawsay Birthing & Wellness Co. and Elijah's Open Arms Foundation.

Failure to follow these expectations may result in suspension or termination of volunteer privileges.
By selecting the box below, I acknowledge that I have read, understand, and agree to the Volunteer Code of Conduct.
Electronic Signature
Date

MonthDayYear
Date
Volunteer Confidentiality & Privacy Agreement

As a volunteer with Mama Kawsay Birthing & Wellness Co. and Elijah's Open Arms Foundation, I understand that I may have access to personal, sensitive, or confidential information regarding clients, families, volunteers, donors, staff members, and community partners.

I agree to:

• Protect the privacy and dignity of every individual served.

• Keep all client and organizational information confidential.

• Not discuss client situations with anyone outside of authorized organizational personnel.

• Not share, photograph, record, screenshot, copy, or distribute confidential information without written authorization.

• Secure any documents or information entrusted to me during my volunteer service.

I understand that confidentiality extends beyond my volunteer service and remains in effect even after my volunteer relationship ends.

Failure to maintain confidentiality may result in immediate termination of volunteer privileges.
By selecting the box below, I acknowledge that I have read, understand, and agree to maintain confidentiality.
Electronic Signature
Date

MonthDayYear
Date
HIPAA CONFIDENTIALITY AGREEMENT

HIPAA Acknowledgement and Confidentiality Agreement

Certain volunteer roles may involve interaction with pregnant women, postpartum mothers, infants, and families receiving support through Mama Kawsay Birthing & Wellness Co.

Although volunteers are not healthcare providers, I understand that I may become aware of protected health information (PHI), including medical, pregnancy, birth, postpartum, mental health, insurance, or personal information.

I agree to:

• Maintain strict confidentiality regarding all health related information.

• Not disclose protected health information to unauthorized individuals.

• Not discuss client information in public settings, social media, group chats, or with family and friends.

• Only access information necessary to perform my volunteer duties.

• Immediately report any accidental disclosure or privacy concern to organizational leadership.

I understand that unauthorized disclosure of protected health information may result in removal from volunteer service and potential legal consequences.
By selecting the box below, I acknowledge that I have read, understand, and agree to comply with HIPAA and privacy requirements.
Electronic Signature
Date

MonthDayYear
Date
SOCIAL MEDIA POLICY

I understand that volunteers may not post, share, discuss, or identify clients, families, children, or confidential organizational information on personal social media accounts.
I understand that photographs of clients, children, or families may only be taken with appropriate written consent.
MEDIA RELEASE AND PHOTO CONSENT

At Mama Kawsay Birthing & Wellness and Elijah's Open Arms Foundation, we love sharing the impact of our programs, events, volunteers, and community partnerships. Photographs, videos, and other media may be used to celebrate our mission, educate the community, and support fundraising efforts.

By signing below, I grant permission to Mama Kawsay Birthing & Wellness Co. and Elijah's Open Arms Foundation to photograph, record, videotape, and otherwise capture my image, likeness, voice, and participation during volunteer activities, events, trainings, meetings, and community programs.

I understand these images and recordings may be used for:

• Social media posts
• Website content
• Marketing materials
• Educational materials
• Newsletters
• Community outreach campaigns
• Fundraising efforts
• Grant applications
• Event promotions
• Printed materials and publications

I understand that no compensation will be provided for the use of these photographs, videos, recordings, or other media.

I further understand that once images are published online or distributed publicly, complete removal may not be possible.

I understand that choosing "No" will not affect my ability to volunteer with either organization.
Please select one of the options below regarding your media preferences.
Electronic Signature
Date

MonthDayYear
Date
BACKGROUND CHECK AUTHORIZATION

Background Check Authorization

To help maintain a safe environment for the families we serve, certain volunteer positions may require a background screening.

By signing below, I authorize Mama Kawsay Birthing & Wellness Co. and Elijah's Open Arms Foundation to conduct a background check when necessary for volunteer positions involving direct interaction with mothers, children, families, or vulnerable populations.

I understand that volunteer eligibility may be contingent upon the results of the screening and that all information obtained will be handled confidentially.
By selecting the box below, I authorize a background screening if required for my volunteer role.
Electronic Signature
Date

MonthDayYear
Date
LIABILITY WAIVER & RELEASE

I understand that volunteer activities may involve certain risks.

I voluntarily assume responsibility for my participation and release Mama Kawsay Birthing & Wellness, Elijah's Open Arms Foundation, their officers, directors, staff, volunteers, affiliates, and community partners from liability for injuries or damages arising from participation except where prohibited by law.
By selecting the box below, I acknowledge that I have read, understand, and agree to the Liability Waiver and Release.
Signature
Date

MonthDayYear
Date
FINAL ACKNOWLEDGEMENT

I acknowledge that I have read, understand, and agree to comply with all policies, agreements, expectations, and procedures contained within this Volunteer Agreement.

I understand that volunteer service is voluntary and may be discontinued by either party at any time.
Electronic Signature
Date

MonthDayYear
Date
Should be Empty:

Village Volunteer Program

Volunteer Information

Volunteer Interest and Placement

Volunteer Acknowledgments