Volunteer Application

Volunteer Application

Armed Services YMCA of Hampton Roads
PLEASE READ BEFORE COMPLETING THIS APPLICATION

Please complete this application if you are interested in volunteering for the Armed Services YMCA of Hampton Roads.

Please use proper capitalization, punctuation, and standard abbreviations when completing your application.

NOTE: Completion of this application does not guarantee acceptance into our volunteer program or availability of your preferred volunteer assignment.

Personal Data
Name:*

First NameMiddle NameLast NameSuffix
Birth Date*

MonthDayYear
Home Phone:*

Area CodePhone Number
Mobile Phone:*

Area CodePhone Number
Email Address:*
example@example.com
Address:*

Street Address & Apt Number

Street Address Line 2

CityState

Zip Code
Military Status:*
Branch:*
Type N/A if not applicable
Rank:*
Type N/A if not applicable

Files Upload

Please upload your up-to-date resume below.
Select Files:

Upload a File

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General Information
Applying to volunteer for:*
Position Location:*
Type of Volunteer:*
Reason to Volunteer:*
T-Shirt Size:*
Branch:*

Hampton Roads
Date Available:*

MonthDayYear
Date
Have you previously applied to volunteer at any ASYMCA or YMCA:*

YesNo
If so when:
What location:
How were you referred to us?*

EmployeeAdvertisementSchoolWalk-InIndeedOther (please specify below)
Other:

Volnteering

List all previous volunteer work, beginning with your most recent. Upload any additional sheets necessary.
Select ONLY if applicable:

I have NO prior experience
Organization:
Start Date:

MonthDayYear
Date
End Date:

MonthDayYear
Date
Address:

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number:

Area CodePhone Number
Supervisor's Title:
Supervisor's Name:

First NameLast Name
List major duties performed:
What did you like MOST about volunteering here:
May we contact this organization while we are considering your application:*

YesNo

Volunteering Continued
Organization:
Start Date:

MonthDayYear
Date
End Date:

MonthDayYear
Date
Address:

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number:

Area CodePhone Number
Supervisor's Title:
Supervisor's Name:

First NameLast Name
List major duties performed:
What did you like MOST about volunteering here?
May we contact this organization while we are considering your application?*

YesNo

Volunteering Continued
Organization:
Start Date:

MonthDayYear
Date
End Date:

MonthDayYear
Date
Address:

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number:

Area CodePhone Number
Supervisor's Title:
Supervisor's Name:

First NameLast Name
List major duties performed:
What did you like MOST about volunteering here?
May we contact this organization while we are considering your application?*

YesNo

Education
High School:
Address:

Street Address

Street Address Line 2

CityState

Zip Code
Diploma:*

YesNoIn ProgressGED
College:
Address:

Street Address

Street Address Line 2

CityState

Zip Code
Course or Major:
Degree:*

YesNoIn ProgressNot Applicable

Special Skills & Training
Describe any other experience, interest, training, or honors received in connection with your previous service. Be sure to include any experiences you would consider relevant to your ability to volunteer for our organization.
Special Skills:*
Enter "none" if not applicable
Training or Certifications:*
Be sure to include Type, Level, and Expiration Date of each. (Enter "none" if not applicable)

Professional References
Reference 1
Name:*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Years Known:*
Reference 2
Name:*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Relationship:*
Phone Number*

Area CodePhone Number
Years Known:*
Reference 3 (May be personal; but not family)
Name:*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Relationship:*
Phone Number*

Area CodePhone Number
Years Known:*

Emergency Contacts
Name:*

First NameLast Name
Relationship:*
Phone Number*

Area CodePhone Number
Name:*

First NameLast Name
Relationship:*
Phone Number*

Area CodePhone Number

PLEASE READ THE BELOW CAREFULLY
I hereby certify that the information provided on this application is accurate to the best of my knowledge and subject to verification by the ASYMCA.
I understand:*

YesNo
I hereby authorize ASYMCA and its representatives to contact my prior places of volunteering and all others identified (with the exception of individuals and/or entities I have marked “No” in response to “May we contact?”) for the purpose of verification of the information I have supplied. I authorize the schools, persons, agencies, and other organizations named in this application to provide ASYMCA (its authorized employees, agents, or representatives) with any relevant information that may be required to arrive at a decision to allow me to volunteer and hereby release any such schools, persons, agencies, and organizations from any and all liability which they might otherwise incur as a result. I understand that any misrepresentation or omission of a material fact on my application may be justification for my refusal to volunteer.
I understand:*

YesNo
While volunteering, I will comply with all rules and regulations as set forth in ASYMCA’s Volunteer Handbook or other communications distributed to volunteers, and understand a condition of my continued volunteering will be my compliance with the ASYMCA’s controlled substance abuse and testing policy, where permissible under applicable State and Local law. I have read, understand, and support the ASYMCA’s position on the problem of child abuse.
I understand:*

YesNo

PLEASE READ THE BELOW CAREFULLY
I further understand, where permissible under applicable State and Local law, I may be subject to a background check to investigate my criminal background, driving record, credit history, and other matters related to my suitability for volunteering. I also understand, where permissible under applicable State and Local law, that depending upon my position, ASYMCA reserves its right to conduct random credit and background checks during the course of my employment. I understand that a separate disclosure and consent form will be provided to me prior to any background check.
I understand:*

YesNo

PLEASE READ THE BELOW CAREFULLY
VOLUNTEER AGREEMENT

I agree to abide by the terms and conditions specified in the Armed Services YMCA Hampton Roads (ASYMCAHR) Volunteer Handbook (including its attached Code of Conduct), which I have reviewed or will review before volunteering my time for the ASYMCAHR. The Handbook is also located online on the Volunteer page of our website using the "View Handbook" button. I understand that if I do not follow the policies and procedures in the Handbook, or act in any way incompatible with the image of the ASYSD, then I will not be able to continue as a volunteer.

CONSENT TO BE PHOTOGRAPHED, VIDEOTAPED, AND FILMED

I hereby grant full permission for myself, my children, and my family members to be photographed, filmed, videotaped, and otherwise recorded by the ASYSD staff and its representatives and such photographs and recordings to be used or licensed by ASYSD for any legitimate purpose relating to its mission, without payment or compensation. I also hereby consent to the participation in interviews and the use of my statements and quotes in publications for the benefit of the ASYSD. I also grant to the ASYSD the right to edit, use, and reuse such products for nonprofit purposes, including use in print, on the Internet, and all other forms of media. I also hereby waive and release the ASYSD and its agents, employees, directors, and representatives, including but not limited to the Armed Services YMCA of the USA (collectively, the “ASYMCA Parties”) from all claims, demands, compensation, and liabilities whatsoever in connection with the above. I understand and agree that the rights and permissions granted above are permanent, perpetual, worldwide, and irrevocable.

CONSENT AND RELEASE OF LIABILITY FOR PROGRAM PARTICIPATION

The individual named below (referred to as "I" or "me") desires to participate in activities offered by ASYMCA either as a participant, volunteer, observer, or in any other capacity (whether singular or plural, hereinafter referred to as the "Activities"). As lawful consideration for participating in the Activities, I agree to all the terms and conditions set forth in this agreement (this "Agreement").

I AM AWARE AND UNDERSTAND THAT THE ACTIVITIES ARE DANGEROUS ACTIVITIES AND INVOLVE THE RISK OF SERIOUS INJURY AND/OR ILLNESS AND/OR DEATH AND/OR PROPERTY DAMAGE. I ACKNOWLEDGE THAT ANY INJURIES THAT I SUSTAIN MAY BE COMPOUNDED BY NEGLIGENT EMERGENCY RESPONSE OR RESCUE OPERATIONS OF ASYMCA. I ACKNOWLEDGE THAT I AM KNOWINGLY AND VOLUNTARILY PARTICIPATING IN THE ACTIVITIES WITH AN EXPRESS UNDERSTANDING OF THE DANGER INVOLVED AND HEREBY AGREE TO ACCEPT AND ASSUME ANY AND ALL RISKS OF INJURY, ILLNESS, DEATH, OR PROPERTY DAMAGE, WHETHER CAUSED BY THE ORDINARY NEGLIGENCE OF ASYMCA OR OTHERWISE.

I hereby expressly waive and release any and all claims which I may have, or which I may hereafter have, whether known or unknown, against the ASYMCA Parties, and its successors, and assigns (collectively, "Releasees"), on account of injury, illness, death, or property damage arising out of or attributable to the Activities, whether arising out of the ordinary negligence of ASYMCA or any Releasees or otherwise. I covenant not to make or bring any such claim against ASYMCA or any other Releasee and forever release and discharge ASYMCA and all other Releasees from liability under such claims. This waiver and release does not extend to claims for gross negligence, intentional or reckless misconduct, or any other liabilities that California law does not permit to be released by agreement.

COVID-19 ADDENDUM

I hereby acknowledge the health risks and dangers associated with the transmission of the COVID-19 virus, and other communicable diseases, and recognize that exposure to the COVID-19 virus, or other communicable diseases, could occur while I am volunteering for the Armed Services YMCA and its programs.

As such, I fully assume all of the risks associated with participation in the Program, including the possibility of COVID-19 (or the novel coronavirus) community spread.

I understand that by signing this release, I am waiving any and all claims, of any kind arising out of or attributable to the Activities, including those claims that may be unknown to me, or which I do not suspect to exist at this time. WITH THE INTENTION OF WAIVING ALL UNKNOWN AND UNSUSPECTED CLAIMS, I HEREBY EXPRESSLY WAIVE ALL RIGHTS, BENEFITS, AND PROTECTIONS I MAY HAVE UNDER CALIFORNIA 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 the debtor or released party.

I shall defend, indemnify, and hold harmless ASYMCA and all other Releasees against any and all losses, damages, liabilities, deficiencies, claims, actions, judgments, settlements, interest, awards, penalties, fines, costs, or expenses of whatever kind, including reasonable attorney fees, fees and the costs of enforcing any right to indemnification under this Agreement, and the cost of pursuing any insurance providers, arising out of or resulting from any claim of a third party related to my participation in the Activities, including any claims arising out of my own negligence or the ordinary negligence of ASYMCA.

This Agreement constitutes the sole and entire agreement of ASYMCA and me with respect to the subject matter contained herein and supersedes all prior and contemporaneous understandings, agreements, representations, and warranties, both written and oral, with respect to such subject matter. If any term or provision of this Agreement is held invalid, illegal, or unenforceable in any jurisdiction, such invalidity, illegality, or unenforceability shall not affect any other term or provision of this Agreement or invalidate or render unenforceable such term or provision in any other jurisdiction. This Agreement is binding on and shall inure to the benefit of ASYMCA and me and their respective heirs, successors, and assigns. All matters arising out of or relating to this Agreement shall be governed by and construed in accordance with the internal laws of the State of Virginia without giving effect to any choice or conflict of law provision or rule (whether of the State of Virginia or any other jurisdiction). Any claim or cause of action arising under this Agreement may be brought only in the federal and state courts located in Virginia Beach City, Virginia and I hereby consent to the exclusive jurisdiction of such courts.

BY SIGNING BELOW, I ACKNOWLEDGE THAT I HAVE READ AND FULLY UNDERSTOOD ALL OF THE TERMS OF THIS AGREEMENT AND THAT I AM VOLUNTARILY GIVING UP SUBSTANTIAL LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE ASYMCA FOR CLAIMS, WHETHER KNOWN OR UNKNOWN, ARISING OUT OF THE ACTIVITIES.
MY SIGNATURE IS EVIDENCE THAT I HAVE READ AND AGREE WITH ALL THE ABOVE STATEMENTS.
Signature:*

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Volunteer Application

Personal Data

Files Upload

General Information

Volnteering

Volunteering Continued

Volunteering Continued

Education

Special Skills & Training

Professional References

Emergency Contacts

PLEASE READ THE BELOW CAREFULLY

PLEASE READ THE BELOW CAREFULLY

PLEASE READ THE BELOW CAREFULLY