YHM Volunteer Application

Answer every question honestly. A "Yes" answer is not an automatic cause for rejection. A false or incomplete answer is grounds for rejection or removal.

Background Check and Reference Authorization

please list three references who are not related to you, and if possible include at least one person who has seen the applicant work or volunteer with youth.

Acknowledgment I have voluntarily applied to serve as a volunteer for Youth Haven Ministries Inc. ("YHM"). I understand that volunteer service is unpaid and does not create an employment relationship with YHM. I understand that I am not entitled to wages, employee benefits, unemployment benefits, workers' compensation benefits, or continued volunteer placement solely because I serve as a volunteer or sign this Agreement. I understand that volunteer activities may include, but are not limited to, youth outreach, mentoring, event coordination, training delivery, educational activities, administrative duties, community engagement, program support, and other tasks authorized by YHM. I acknowledge that I have read this entire Agreement, understand its terms, and agree to it freely and voluntarily. I am not relying on any oral statement, representation, assurance, or promise that is not contained in this Agreement.

Assumption of Risk I understand that volunteer service may involve foreseeable and unforeseen risks, including but not limited to physical injury; illness, including exposure to communicable illness; property damage, theft, or loss; travel-related risks; emotional stress; challenging interpersonal interactions; exposure to trauma, crisis, or other sensitive circumstances; risks associated with community outreach, events, facilities, outdoor activities, and interactions with participants, families, volunteers, staff, or members of the public; and risks associated with providing or receiving first aid or emergency assistance. I voluntarily choose to participate in YHM volunteer activities and knowingly assume all risks that are inherent in, arise from, or are associated with volunteer service, including risks that may result from the ordinary negligence of YHM or a Released Party, to the fullest extent permitted by West Virginia law. I agree to comply with all applicable laws and all YHM safety, child-protection, conduct, transportation, communication, confidentiality, emergency, and reporting policies and procedures.

Release of Liability To the fullest extent permitted by West Virginia law, I, for myself and for my heirs, personal representatives, successors, and assigns, release, waive, and discharge Youth Haven Ministries Inc. and its current and former directors, officers, employees, agents, representatives, volunteers, program leaders, contractors, and insurers (collectively, the "Released Parties") from all claims, demands, causes of action, damages, losses, costs, and expenses arising from or related to my volunteer service with YHM when caused by the ordinary negligence of any Released Party. This release includes claims involving bodily injury, personal injury, illness, disease, death, damage to or loss of personal property, emotional distress, psychological injury, and first aid, emergency assistance, or emergency medical services that may be requested, arranged, provided, or not provided in connection with volunteer activities. This release also includes incidents occurring while participating in, traveling to, traveling from, or otherwise connected with authorized YHM volunteer activities. This Agreement does not release or waive claims arising from gross negligence, reckless conduct, willful or wanton misconduct, intentional misconduct, criminal conduct, or any liability that cannot lawfully be waived under applicable law. I understand that this release applies only to my own claims and is not intended to waive the rights of any child, participant, parent, guardian, or other third party.

Insurance and Emergency Assistance I understand that, unless YHM provides written notice otherwise, YHM does not provide volunteers with medical, health, accident, disability, automobile, or workers' compensation insurance coverage. I am responsible for maintaining any insurance coverage I wish to have and for my own medical expenses, deductibles, co-pays, transportation costs, lost income, and other personal expenses arising from injury, illness, or loss, except to the extent another source of coverage or applicable law applies. If YHM authorizes me in writing to drive for any YHM activity, I will hold a valid driver's license and the vehicle insurance required by law, and I will provide proof of both on request. If I become ill, injured, or incapacitated, or experience a medical emergency during volunteer service, I authorize YHM personnel to seek emergency medical evaluation, treatment, transportation, or assistance for me when they reasonably believe it is necessary. I understand that YHM cannot guarantee the availability, timing, quality, or outcome of emergency medical care. I remain responsible for associated medical, transportation, and related costs unless they are paid by insurance or another source.

Child Safety, Prohibited Contact, and Mandated Reporting I understand that YHM serves or may serve children, youth, and vulnerable individuals. I agree to comply with all YHM child-protection, safeguarding, supervision, boundaries, communication, transportation, safety, and incident-reporting requirements. I will not have one-on-one unsupervised contact with any minor participating in, served by, or connected with YHM. I will not meet with, transport, communicate privately with, supervise, mentor, counsel, or otherwise interact alone with a minor unless YHM has expressly authorized the contact in advance and the contact complies with YHM's written child-protection and supervision procedures. I will not request, collect, exchange, store, or use a minor's personal contact information, including a personal phone number, email address, home address, social-media account, messaging-platform account, gaming-platform account, or other private electronic contact information, unless YHM has expressly authorized it in writing and any required parent or legal guardian consent has been obtained. I will not communicate with a minor through personal social-media accounts, personal text messages, private messaging, direct messages, email, gaming platforms, or any other private electronic communication method. Any YHM-authorized communication with a minor must occur through approved YHM communication channels, with appropriate adult oversight and, when required by YHM policy, inclusion of the minor's parent or legal guardian. West Virginia. I understand that West Virginia law requires a volunteer of an entity that provides organized activities for children to report suspected child abuse or neglect when the volunteer has reasonable cause to suspect that a child has been abused or neglected, including sexual abuse or sexual assault, or observes a child being subjected to conditions likely to result in abuse or neglect. I will make any legally required report immediately, and no later than 24 hours after forming the suspicion, to the West Virginia Department of Human Services Centralized Intake hotline at 1-800-352-6513. If I believe a child has suffered serious physical abuse, sexual abuse, or sexual assault, I understand that West Virginia law also requires me to immediately report the matter to the West Virginia State Police and the law-enforcement agency with jurisdiction to investigate the complaint. Florida. If I volunteer in Florida, I understand that Florida law requires any person who knows, or has reasonable cause to suspect, that a child is abused, abandoned, or neglected to report it immediately to the Florida Abuse Hotline at 1-800-962-2873 (1-800-96-ABUSE). Other states. If I volunteer in any other state, I will follow that state's reporting law and YHM's reporting instructions for that state. Emergencies. If a child is in immediate danger, I will call 911 first. I understand that reporting a concern to a YHM supervisor, director, board member, employee, volunteer leader, pastor, or other person does not replace my personal legal obligation to make a required report to the appropriate authorities. I will also immediately notify YHM's designated leader or agent of any suspected abuse-or-neglect report, concern, incident, boundary violation, or suspected misconduct, unless doing so would interfere with law enforcement, child-protective services, or another legal requirement. A violation of YHM's child-safety, supervision, boundaries, communication, transportation, or reporting requirements may result in immediate suspension, removal, restriction, reassignment, or termination of volunteer service, without prior notice, in YHM's sole discretion. YHM may investigate a suspected violation and may report the matter to a parent or legal guardian, child-protection authorities, law enforcement, or other appropriate authorities when required by law or when YHM reasonably determines that a report is necessary to protect a minor, comply with law, or address suspected abuse, neglect, exploitation, grooming, criminal conduct, or another safety concern.

Agreement to Abide by YHM Policies and Procedures If accepted as a volunteer with YHM, I agree to comply with all current and future YHM policies, procedures, rules, safety requirements, child-protection and safeguarding requirements, confidentiality obligations, conduct standards, communication rules, transportation requirements, emergency procedures, and reporting requirements that apply to my volunteer role. I understand that YHM may revise, adopt, or update its policies and procedures as needed. I agree to comply with any revised or additional policy after YHM provides notice of the policy or makes it reasonably available to me. I understand that failure to comply with YHM policies, procedures, or this Agreement may result in suspension, restriction, reassignment, removal, or termination of my volunteer service. YHM may take immediate action, including removal from volunteer activities, when YHM reasonably determines that action is necessary to protect participants, volunteers, staff, the public, or YHM property; to investigate a concern; or to comply with law or organizational requirements.

Confidentiality and Privacy During my volunteer service, I may receive or learn nonpublic information about YHM, its participants, families, volunteers, employees, donors, programs, operations, finances, personnel matters, safety incidents, or strategic plans ("Confidential Information"). I will use Confidential Information only as necessary to perform authorized YHM volunteer duties. I will protect Confidential Information from unauthorized access, disclosure, copying, photography, recording, posting, sharing, or distribution. I will not discuss or share participant information, participant circumstances, family matters, medical information, educational information, safety matters, donor information, personnel matters, or internal YHM business with any person who does not have a legitimate need and authorization to know. I will not post, transmit, or share identifying information, photographs, video, audio, messages, stories, or other content involving YHM participants through personal social-media accounts, websites, text messages, email, or other media unless YHM expressly authorizes it in writing and all required permissions have been obtained. Confidential Information does not include information that becomes publicly available through no breach of this Agreement, was lawfully known to me before I received it through YHM, or is lawfully received from a source not subject to a confidentiality obligation. Nothing in this Agreement prohibits me from making a good-faith report of suspected abuse, neglect, criminal conduct, discrimination, harassment, unsafe conditions, financial misconduct, or other suspected violations of law or policy to appropriate authorities or persons authorized to receive the report. Nothing in this Agreement limits disclosures required by law, subpoena, court order, or governmental investigation. My obligations concerning participant information, personal information, protected information, and nonpublic YHM information survive the end of my volunteer service for as long as the information remains confidential or protected by law. Unauthorized disclosure may result in removal from volunteer service and legal action where permitted by law.

Required Media, Photograph, Video, and Audio Release I understand that permission for YHM to photograph, video record, and/or audio record me is a required condition of volunteer service with YHM. By signing this Agreement, I grant Youth Haven Ministries Inc. an irrevocable, perpetual, worldwide, royalty-free right and permission to photograph, film, video record, audio record, reproduce, edit, adapt, publish, display, distribute, transmit, archive, and otherwise use my name, image, likeness, voice, statements, photographs, video, and audio recordings created in connection with my YHM volunteer service. YHM may use these materials for legitimate nonprofit, charitable, educational, ministry, informational, fundraising, donor-reporting, grant-reporting, volunteer-recruitment, training, archival, website, newsletter, social-media, print, digital, broadcast, and promotional purposes, in any format or medium now known or later developed. I understand and agree that I will receive no compensation, royalties, approval rights, ownership interest, or other payment for such use. YHM is not required to use any photograph, recording, or other material containing my name, image, voice, likeness, or statements. YHM may edit, crop, combine, modify, reproduce, distribute, publish, archive, or discontinue use of the materials in its discretion, provided that YHM will not knowingly use the materials in a false, defamatory, unlawful, or materially misleading manner. I waive any right to inspect, approve, or receive notice of the finished materials or their use. I release and hold harmless YHM and the Released Parties from claims arising from YHM's authorized use of these materials, including claims based on invasion of privacy, right of publicity, misappropriation of likeness, or similar claims, except to the extent caused by YHM's gross negligence, reckless conduct, intentional misconduct, or unlawful use. Safety exception. If I have a personal safety reason that my name or image should not be published (for example, someone may be trying to locate me), I may tell YHM's designated leader privately, in writing. YHM will then not publicly publish my name or identifiable image, and this exception does not otherwise affect my eligibility to volunteer. This media release survives the end of my volunteer service.

Authority, Governing Law, and Severability I understand that I may not represent that I speak for YHM, bind YHM to a contract, make commitments on behalf of YHM, solicit funds in YHM's name, provide professional counseling or clinical services outside my qualifications and authorized role, or make promises to participants, families, donors, vendors, or the public unless YHM has specifically authorized me to do so. This Agreement is governed by and interpreted under the laws of the State of West Virginia. If any provision of this Agreement is found invalid, unlawful, or unenforceable, that provision will be enforced to the maximum extent permitted by law or severed to the minimum extent necessary, and the remainder of the Agreement will remain in effect.

Instruction