Program Volunteer Application Form

Program Volunteer Application Form

Please complete the form below to apply for a volunteer position with us.
Full Name*

First NameLast Name
Pronouns
Phone Number*

Area CodePhone Number
Email Address*
Do you give permission to be added to our volunteer mailing list (for updates on upcoming volunteer and trainings opportunities at Elevation Outdoors)?*

YesNo
Date of Birth*

MonthDayYear
Birthdate
Current Address*

Street Address

Street Address Line 2

CityProvince

Postal CodeCountry
Do you self-identify as indigenous? - All information will be kept confidential in accordance with federal law and does not affect your eligibility for volunteering with our programs, we collect this information to provide volunteer demographics to our funders.*

YesNoPrefer not to answer
If you answered 'yes' to the previous question, please select from list below:*
How did you hear about us?*
What type of volunteer role are you interested in (select all that apply)?

Get a Grip: Rock Climbing Program VolunteerLeaders in Action: Longer-term Mentorship Program VolunteerLearn to Shred: Snowboarding Program VolunteerLive to Ride: Mountain Biking Program VolunteerReady to Roll: Skateboarding Program VolunteerTake a Hike: Hiking Program VolunteerEvent Volunteer (ie. ticket takers, bartender, general support, etc.)Media Capture/Compilation Volunteer (if you have experience with photo/video capturing and editing, we could utilize your skills during and after our programs)Class 4 DriverOther
Let us know a bit more about your interest in volunteering with Elevation Outdoors! What are your strengths, interests, and experience? Do you have any special skills or interests that could benefit our youth or programs?*
Do you have experience working with youth?*

YesNo
Please give details
What are your reasons for wanting to volunteer with Elevation Outdoors?*
If you are applying to volunteer with our Learn to Shred program, do you have a Big White Season's pass?*

YesNoN/A - I am not apply for Learn to ShredOther
Are you able to meet at a central location (Orchard Park, West Kelowna Xtreme Theatre, or Rutland 7-11) for transport to the program? *
Please select any of the following special certifications you have (these are not required to volunteer with Elevation Outdoors, though may provide more opportunities)

Class 1, 2, or 4 (Unrestricted) Driver's LicenceFirst Aid CertificationPMBIA or other MTB Instructor CertificationCASI CertificationClimbing Instructor DesignationOther
Can you provide a background/police check?*

YesNo
Please list 2 references*
Confidentiality Agreement

1. I acknowledge and confirm that as a volunteer at Elevation Outdoor Experiential Programs Association (Elevation) I may acquire information on the organization, its clients, participants, staff, and volunteers, and about certain matters and things which are of a confidential nature and that such information is the exclusive property of the organization and will remain in the strictest confidence.

2. I affirm that the information referred to above could be used to the detriment of the organization and volunteer activities and thereby undertake to treat as confidential all information, data, documents, manuals, contact information, contracts, or resources and all information treated as proprietary by Elevation. I agree not to disclose the same to any third party either during the term I am volunteering for Elevation or at any time thereafter unless required by law.

3. I agree that any knowledge gained as a result of my position with Elevation will remain in strictest confidence. I will not make use of the confidential information or disclose any confidential information except to the extent required to carry out my duties as a volunteer of Elevation.

4. I agree to exercise due care to protect the confidential information from inadvertent dissemination, including taking all appropriate measures to protect data sent by electronic transmission, and to ensure that any information I may give to others in the course of my duties as a volunteer or otherwise is information that is required to be given and is given to a party entitled to receive such information.

5. I agree that I will not discuss the details of my volunteer work with any representatives of the media or publicize any of the confidential aspects of my work orally or by written work or any other medium of communication, without the prior written consent of Elevation.

6. I acknowledge that my failure to comply with the confidentiality policies of the organization may result in disciplinary actions including possible dismissal.
I confirm that I have read the above statements and agree with them; I will therefor adhere to all confidentiality requirements contained in this agreement or as may be otherwise authorized by a current executive member.*

YesNo
Signature for Confidentiality Agreement*
Date of Signature*

MonthDayYear
Date
Witness Signature*
Name of Witness*
Elevation Outdoors Image/Media Release Form

I hereby give my permission to Elevation Outdoors to use my image/photograph and/or video capture or likeness of me.

I understand that the above-mentioned images may appear in various formats/publications associated with Elevation Outdoors and will be released into public domain, which may include other outside media, to promote Elevation Outdoors and its programs as well as fundraising efforts.

I understand that the above mentioned images may appear on the Elevation Outdoors website or social media channels and will therefore be released into public domain.
Signature for Image/Media Release Form
Date of Signature*

MonthDayYear
Date
Witness Signature
Name of Witness*
Volunteer Medical Information
BC Med Care Card #
Emergency Contact Name*
Emergency Contact Phone Number*
Medical History
Have you ever suffered any form of Asthma?*

YesNo
If yes to previous question, do you take any medication for it? What type?
Do you suffer from any form of allergy?*

YesNo
If yes to previous question, what are you allergic to and what, if any, medication is taken?
Do you have any dietary restrictions (some of our program provide snacks, lunch, or dinner)?*
Do you have any of the following conditions?

PhobiasEpilepsyDiabetesHeart conditionSeeing disordersHearing disordersBleeding disorderMigraines/headachesAnkle/knee/joint problemsConcussion (historic or current)
Please provide details of questions for which a check was indicated:
Date of last Tetanus injection? (If not within last 10 yrs, participant may receive a tetanus injection by medical officer if they receive a tetanus prone wound)*
Are you on any ongoing medication?*

YesNo
If yes to previous question, please provide details of medications, dosage and frequency taken:
In the case of accident or illness, I authorize the caregiver to administer first aid and/or to be taken to the nearest emergency centre. I consent to receive medical treatment. I consent that in the event of severe illness/injury the means of transportation may be by ambulance at a cost to myself.*

YesNo
Is there anything else about you, medical or otherwise, we should know?
Initial for above statement
I Declare that the information which I have provided on this form is complete and correct and that I will notify the program if any changes occur. I authorize the facilitator to consent to receive such medical or surgical treatment as may be deemed necessary.
Signature for above statement
Date of Signature*

MonthDayYear
Date
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