Level Up 2024 Youth Mental Wellness Conference Volunteer Application

Your Name*

First NameLast Name

Parent/Guardian Name (if under the age of 18)

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email*

example@example.com

Phone Number*

Demographics: Please select the group you most identify with.*

Please select the group you most identify with. If none apply leave blank

High School StudentCollege StudentVeteranFoster youth/Former Foster youth

If selected other to the previous question, please list demographic information here.

Do you need accommodation services in order to perform your duties?*

YesNo

If you selected yes to the previous questions, please provide details here.

Please enter what type of accommodation services do you need. Please indicate n/a if previous answer was no.*

Emergency Contacts*

Education Level*

School Name (Please complete if you are currently enrolled in school)

Birthdate*

Date

How did you find this volunteer opportunity?*

If you selected other, please provide details.

Availability Information *

	7:00AM-7:30PM	7:00AM - 12:00PM	11:30 AM - 7:30 PM	7:00AM - 10:00AM	4:00PM - 8:00PM
Saturday
Sunday

Why do you want to be a volunteer in this program?*

Are you currently employed? if so, what is your job title? Please summarize your duties and how they might align with volunteer opportunity.*

Do you have experience volunteering with youth? If so, please provide details.*

Please tell us about your other volunteering or work experiences.*

What are your interests?*

Please share your skills that may assist with this volunteer opportunity?*

ie. Graphic Design, Social Media

To assure we provide an environment that is safe for our youth, All volunteers are required to do a background check. Are you ok with background check (relevant to volunteer opportunity only). Once you application is submitted and reviewed, we will process back ground check. This will need to be done within a week of submitting your application. PLEASE complete application and we will contact you. If your employer requires a background check-you already had one this year- please note here. HIGH SCHOOL/COLLEGE STUDENTS PLEASE SKIP THIS SECTION. THIS DOES NOT APPLY TO YOU.*

I, blanks , (hereafter the “Undersigned”) being an adult over the age
of eighteen (18), desire to participate in the Level Up Youth Mental Wellness retreat by The Growth Center I, Inc. Please add appropriate blank fields and text.

Waiver and Release of Liability

The Undersigned is fully aware of the risks and hazards connected with Level UP Youth Mental Wellness Conference and hereby elects to voluntarily participate in said Activity, knowing that the Activity may be hazardous to me and my property. THE UNDERSIGNED VOLUNTARILY ASSUMES FULL RESPONSIBILITY FOR ANY RISK OF LOSS, PROPERTY DAMAGE OR PERSONAL INJURY, INCLUDING DEATH, which otherwise may be sustained as a result of being engaged in such Activity.

1. In exchange for participating in the Activity, the Undersigned on behalf of his or her self, heirs, estate, insurers,representatives and assigns hereby fully releases, waives, discharges and covenants not to sue the Growth Center I, Inc., its employees, elected and appointed officials, volunteers, attorneys, agents and any other person(s) acting on the The Growth Center's behalf (hereafter the ‘Releasees’) from any and all claims for bodily injury (including death), and other liability, damages, lawsuits, expenses (including but not limited to, medical expenses and attorneys’ fees) to the Undersigned or any other person, arising out of or relating to the Undersigned’s participation in the Activity and agrees to waive any rights to make the above claims through a lawsuit or
otherwise against the Releasees above.

2. The Undersigned understands and acknowledges responsibility for any injury or damage the Undersigned causes to others during the Level Up Youth Mental Wellness Conference and hereby agrees to indemnify, defend, and hold harmless the Releasees
from any and all claims for bodily injury (including death), and other liability, damages, lawsuits, expenses (including but not limited to, medical expenses and attorneys’ fees) caused by my negligence or willful misconduct, in the performance of activities at the Level Up Youth Mental Wellness Conference.

3. COVID-19: By signing this waiver to volunteer with the Growth Center I, Inc. the Undersigned, acknowledges that you have read, understand, and will comply with all measures outlined by the State of California Governor’s Office as outlined at www.COVID.CA.GOV, as well as any restrictions put in place by the Sacramento County Health Services Agency as they pertain to safety and preparedness for COVID-19. All volunteers are encouraged to stay home should they have a fever or other COVID-19 symptoms. Volunteers must comply with all state and
local social distancing requirements, and wearing a mask. Individuals deemed high risk by the CDC or CA Department of Public Health, including those with
underlying medical conditions are responsible for reading and understanding the following CDC guidance for groups of people with an increased risk for severe illness: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/index.html.

By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19 by participating in this program, and I hold The Growth Center I, Inc.
harmless from any and all COVID- 19 related liability or responsibility due to my participation in the Level Up Youth Mental Wellness Conference on November 9th & 10th 2024.

4. The Undersigned hereby grant to The Growth Center I, Inc and their legal representatives and assigns, the irrevocable and unrestricted right to use and publish photographs of me, for advertising and any other promotional purposes and in any manner and medium; to alter the same without restriction; and to copyright
the same. I hereby release The Growth Center I, Inc. and their legal representatives and assigns from all claims and liability relating to said photographs.

5. The Undersigned expressly agrees that the foregoing release and waiver and indemnity agreement are intended to be as broad and inclusive as permitted by California law.

6. The Undersigned understands and covenants that this Agreement shall apply to all unknown and unanticipated claims, injuries, causes of action and damages, as well as any known claims, and waives the provisions of Civil Code Section 1542, which reads as follows: “A general release does not extend to claims that the creditor or releasing party does not know or suspect to exist in his or her favor at the time of executing
the release and that, if known by him or her, would have materially affected his or her settlement with thedebtor or released party.”

By signing below, I blanks acknowledge and represent that I have read this agreement carefully; I fully understand it and I voluntarily agree to its terms. No oral representations, statements or inducement, apart from this written agreement have been made. If any portion of this agreement is declared invalid by a court, the remainder shall continue in full force and effect.

Participant Signature*

Parent Signature*

Photographic & Volunteer Release

I hereby acknowledge that the information given above is accurate and I give permission to The Growth Center I, Inc. community for the use of my photographs that are taken by staff in order to use for social media, flyers and website post promoting The Growth Center I, Inc. programs for youth.

Volunteer Candidate Signature*

Parent of Candidate Signature*