Volunteer Application Form

The information collected in this application will be held in strict confidence and will be treated with utmost respect for your privacy.
Please consider this my formal application to volunteer in the following program.(Required)
Name(Required)
Address(Required)
Have you ever been, or applied to be, a volunteer with a Big Brothers Big Sisters agency in the past?(Required)
Do you have a Motor Vehicle Available?
Only answer this question if applying to be a Big.
Only answer this question if applying to be a Big.
Do you have at least $1 million in auto insurance coverage?
Only answer this question if applying to be a Big.
Have you been charged with any traffic violations or had your license suspended?
Only answer this question if applying to be a Big.
Only answer this question if applying to be a Big.
Do you have pets?
Only answer this question if applying to be a Big.
Only answer this question if applying to be a Big.
Have you been arrested, charged, convicted or pardoned of a criminal offence?(Required)
Have you ever been accused, arrested, convicted or pardoned of a sexual offense involving a child or children?(Required)

REFERENCES

The Agency requires the names of THREE references for every volunteer candidate. The agency will be contacting each person regarding your application. Complete the following information fully and legibly. PLEASE SUPPLY PHONE AND E-MAIL ADDRESSES FOR FASTER RESPONSE. Be sure to let your Reference people know we will be contacting them.
Address of Personal Reference(Required)
Please provide a reference(s) if you have worked with or volunteered with a person or organization responsible for the well-being of children under the age of 18 or with vulnerable persons who, because of their age, a disability, or other circumstances are at greater risk than the general population of being harmed by a person in a position of authority or trust relative to them.
Address of Vulnerable Sector (or other) Reference(Required)
Address of Significant Other Reference(Required)
Address of Teacher Reference
VOLUNTEER PERMISSION AND RELEASE AGREEMENT TO: BIG BROTHERS BIG SISTERS OF SAINT JOHN (THE “AGENCY”) The Agency and Big Brothers Big Sisters Canada (“BBBSC”) are separate entities and this Agreement is between me and the Agency. 1. By applying to volunteer with the Agency (“Volunteer Application”) and signing this Agreement, I acknowledge, understand and accept that: (a) I am a legal resident of Canada and have reached the age of majority in the province or territory in which I reside. I acknowledge and agree that if I have not reached the age of majority of the province or territory in which I reside, my parent or legal guardian will also need to sign this Agreement in order for my Volunteer Application to be considered; (b) There is no obligation on the Agency to accept my Volunteer Application or assign me as a volunteer into a mentoring program (a “Mentoring Program”) and the Agency may terminate my involvement in a Mentoring Program in its sole discretion and without reason; (c) If I am accepted as a volunteer, my involvement in a Mentoring Program is not intended to create and shall not be construed as creating either an employee–employer relationship or a contract for services that would allow me to receive a salary, compensation, payment or any benefits, monetary or otherwise; and (d) If I am accepted into a Mentoring Program, I understand that I will be required to enter into a confidentiality agreement with the Agency, and I agree to abide by the volunteer position description(s) and code(s) of conduct established by the Agency, including any applicable guidelines, Standards and policies. 2. Assumption of Risk, Release and Reimbursement: I acknowledge, understand and accept that: (a) I am responsible for all risks associated with my involvement in a Mentoring Program including, without limitation, the risk of bodily or psychological harm or injury. (b) Subject to local laws, I agree not to sue the Agency, BBBSC and/or any of their member agencies in respect of any such injury or claim resulting from my participation in a Mentoring Program, my Volunteer Application, the acceptance or denial of my Volunteer Application, the Alumni Program and/or my association with the Agency or BBBSC. (c) I understand that I am fully responsible for any damage to my personal vehicle and/or property during my volunteer involvement in a Mentoring Program and that neither BBBSC nor the Agency insures personal vehicles or property belonging to its volunteers; (d) I agree to reimburse the Agency and/or BBBSC and/or any of their member agencies for any damages or losses of any kind (including but not limited to the injury of any other person and/or damage to or loss of property) that may arise in connection with my gross negligence, wilful misconduct, or failure to act in accordance with published BBSC policies and guidelines and relating to or arising in connection with my participation in a Mentoring Program or my association with the Agency or BBBSC, including payment of any and all legal expenses of the Agency, BBBSC and/or any of their member agencies. 3. Background Check. I understand that my acceptance into the Mentoring Program will be conditional on my successful completion of a background check, which may include contacting the references included in my Volunteer Application and/or a criminal record check, for the purposes of confirming my suitability for the Mentoring Program. I agree to provide all necessary consents for such background checks. 4. Privacy Notice. The personal information provided by me or otherwise collected by the Agency in connection with my application will be used by the Agency for the purpose of evaluating and considering my Volunteer Application and, if accepted into a Mentoring Program, for the purpose of administering the Mentoring Program. This information may include my name, phone number, mailing address, date of birth, results of background check, and driver’s license and auto insurance information. My personal information will be maintained by the Agency on a confidential basis and will only be disclosed to the parent(s) and/or guardian(s) of a child with whom the Agency may consider “matching” me in a Mentoring Program, to representatives of a school or institution in connection with my participation in a site-based Mentoring Program, to the BBBSC as required for the purposes of accreditation reviews or legal proceedings and as otherwise required or permitted by law. In the event the Agency ceases operations, any and all information about me held by the Agency will be provided to BBBSC, another BBBSC agency selected by BBBSC, or both and will be used for the purposes set out above. In the event where it is deemed necessary, any and all information about me held by the agency will be provided to BBBSC, another BBBSC agency selected by BBBSC, or both and will be used for the purposes set out above. No information will be provided to persons or organizations outside of Big Brothers Big Sisters of Canada, and its agencies, about parents, children or volunteers without their express prior written consent except where required by law. 5. Other Terms of this Agreement. (a) In entering into this Agreement, I am not relying on any oral or written representations other than as set forth in this Agreement. (b) This Agreement shall be governed by and construed pursuant to the laws of the Province or Territory in which the Agency is located. (c) In the event that any provision or term of this Agreement is held to be invalid, illegal or unenforceable, the remaining provisions of this Agreement shall remain in full force and effect. 6. Media Consent. Any photographs or video productions taken of volunteers by agency staff at recreational events or match outings, or otherwise authorized by the Executive Director or Board of Directors, may be used by the agency for purposes of promotional material including brochures posters, newsletters, media information, advertisements, audio-visual productions and web pages, such as the Agency website and social media. Photographs or video productions may also be shared with community and school partners and Big Brothers Big Sisters of Canada for program promotion.
By entering my name below, I (and my parent/guardian if under 18, i.e. Teen Mentor) agree with item #6 Media Consent in the above Volunteer Permission and Agreement Form(Required)
IMPORTANT: I acknowledge that I have read the terms of the Volunteer Permission and Agreement form, have been given an opportunity to obtain independent legal advice, and understand that it represents a waiver of certain of my (on my own behalf or on behalf of my child if they are under 18 years of age) legal rights, including my right to sue (subject to local laws). I further agree that such limits are reasonable and sign this Agreement (on my own behalf or on behalf of my child if they are under 18 years of age) freely, voluntarily and without duress.(Required)
I agree that the information submitted through this entire form is true to the best of my knowledge.(Required)
By clicking on SUBMIT, I certify that I am signing this application form (on my own behalf or on behalf of my child if they are under 18 years of age) (i.e. Teen Mentor)(Required)