C.A.E. Volunteer Application w/ Waiver

C.A.E. Volunteer Application

A C.A.E. Team Representative will contact you within 24 hours.
Name *

Prefix First Name Last Name
Address *

Street Address

Street Address Line 2

City State

Zip Code
Date of Birth *

Month Day Year
Email *
example@example.com
Phone Number *

Area Code Phone Number
Social Media Handles
i.e. Facebook, LinkedIn and Instagram Name(s)
Are you a convicted felon? *
Have you completed an FBI/BCI background check? *
Do you have reliable transportation? *
SKILLS AND QUALIFICATIONS
Please check all area(s) of expertise that applies:

Administrative: Grant-writing/Fundraising/Social Media/Blog/Writing Business: Entrepreneurship/Marketing/Workforce Development Community: Networking/Service Culinary Arts: Baking/Cooking/Catering/Food Truck Development: Social & Emotional (Youth/Adult)/Leadership Development Education: Financial/Academic Tutoring/ACT/SAT/GED Events: Planning/Decorating/Ticket Sales Health & Fitness: Nutrition/Strength & Conditioning/Recreation/Sports Multimedia: Photography/Video/Web Design/Graphic Design/Film Performing Arts: Music/Theatre/Dance/Spoken Word Technology: Coding/Robotics Trade: Electrical/Mechanic/Auto Body/Construction/Sewing
May we contact you if a need arises for your area of expertise? *
VOLUNTEER OPPORTUNITIES

For more information about C.A.E.'s Countywide Initiative, please visit www.caeww.com/stomp
Which C.A.E. branded workshop do you have the most interest in helping with?

C.A.E.'s Students Taking Ownership Mentoring Project "S.T.O.M.P." (Character & Leadership Development and Civic Awareness) C.A.E.'s SWAGG Station Web Show (Dance & Media) C.A.E.'s Makin' the Band Web Show (Music & Media) C.A.E./Camp Tech 360 Experience (Technology) C.A.E.'s The LEGITIMATE Hustle (Business & Culinary Arts) C.A.E.'s Arts-N-Motion (Health & Fitness, Media and Dance) C.A.E.'s Young Enterprise Money Maker$ (Entrepreneurship) C.A.E.'s Positive Disruption (Social & Emotional Development) C.A.E. TV Productions (Media & Film) C.A.E. Concession Stand Management Not sure at this present time
How much time would you be willing to volunteer? *

One Hour Per Week Two Hours Per Week Three Hours Per Week Four or More Hours Per Week
What specific days and times are you available to volunteer? *
i.e. Monday - 4pm to 6pm
How comfortable do you feel speaking in front of a group of people? *

Extremely Comfortable Comfortable Somewhat Comfortable Not Comfortable
VOLUNTEER WORK
Please list your previous volunteer work
Please list your current community activities
clubs, religious, fraternal and civic organizations
How did you learn about C.A.E? *
REFERENCES

Please list three references over the age of 21 and not a family member. *

	Name	Address/Zip code	Phone	Relationship
Reference
Reference
Reference

VOLUNTEER RELEASE & WAIVER OF LIABILITY
This Release and Waiver of Liability (the “release”) executed on Date by,   First Name   Last Name (“Volunteer”) releases Community Arts Experience, Inc. (C.A.E.), (“Nonprofit”), a nonprofit corporation organized and existing under the laws of the State of Pennsylvania and each of its directors, officers, employees, volunteers, project collaborators, and agents. The Volunteer desires to provide volunteer services for Nonprofit and engage in activities related to serving as a volunteer.

Volunteer understands that the scope of Volunteer’s relationship with Nonprofit is limited to a volunteer position and that no compensation is expected in return for services provided by Volunteer; that Nonprofit will not provide any benefits traditionally associated with employment to Volunteer; and that Volunteer is responsible for his/her own insurance coverage in the event of personal injury or illness as a result of Volunteer’s services to Nonprofit.

1.     Waiver and Release: I hereby release and forever discharge and hold harmless Nonprofit and its successors and assigns from any and all liability, claims, and demands of whatever kind of nature, either in law or in equity, which arises or may hereafter arise from the services I provide to Nonprofit. I understand and acknowledge that this Release discharges Nonprofit from any liability or claim I may have against Nonprofit concerning bodily injury, personal injury, illness, death, or property damage that may result from the services I provide Nonprofit or occurring while I am providing volunteer services.

2.     Insurance: Further, I understand that Nonprofit does not assume any responsibility for or obligation to provide me with financial or other assistance, including but not limited to medical, health, or disability benefits or insurance. I expressly waive any such claim for compensation or liability on the part of the Nonprofit and each of its directors, officers, employees, volunteers, project collaborators, and agents beyond what may be offered freely by the Nonprofit in the event of injury or medical expenses incurred by me.

3.     Medical Treatment: I hereby release and forever discharge Nonprofit from any claim whatsoever which arises or may hereafter arise on account of any first-aid treatment or other medical services rendered in connection with an emergency during my tenure as a volunteer with Nonprofit.

4.     Assumption of Risk: I understand as a volunteer, I hereby expressly assume the risk of injury or harm from activities associated with the Nonprofit and Release Nonprofit and each of its directors, officers, employees, volunteers, project collaborators and agents from all liability.

5.     Photographic Release: I grant and convey to Nonprofit all rights, titles, and interests in any and all photographs, images, videos, or audio recordings of me or my likeness or voice made by Nonprofit in connection with my providing volunteer services to Nonprofit.

6.     Other: As a volunteer, I expressly agree that this Release is intended to be as broad and inclusive as permitted by the laws of the State of Pennsylvania and that this Release shall be governed by and interpreted in accordance with the laws of the State of Pennsylvania. I agree that if any clause or provision of this Release is deemed invalid, the enforceability of the remaining provisions of this Release shall not be affected.
ATTESTATION
By signing below, I express my understanding and intent to enter into this Release and Waiver of Liability willingly and voluntarily.
- I certify that the information in this application is true and correct to the best of my knowledge.
- I give consent that my references may respond to a verbal or written request for further information from C.A.E.
- I am willing to undergo a background check.
- I understand that I must complete a training period before working with C.A.E.
- I agree to sign a Confidentiality Agreement.
- I understand that my application and all information contained herein will be held in strict confidence by C.A.E. and will not be released to any outside party without the applicant’s consent.
E-Signature *
The electronic signature, whether digital or encrypted, is intended to authenticate this document and to have the same force and effect as a manual signature.
For Office Use Only:

	#1 Interview Date	#2 Interview Date	Approved/Denied	Notes
LaShay Nixon, CLO
B.J. Pleasant. CEO

Should be Empty:

C.A.E. Volunteer Application

VOLUNTEER RELEASE & WAIVER OF LIABILITY