YVC OF TOPEKA
What is YVC?
What is YVC?
Thank you for signing up with Youth Volunteer Corps of Topeka!
Be sure to complete the following waiver if you have not already.
YVC Youth Volunteer Profile and Parent/Legal Guardian Waiver
THIS IS A LEGAL DOCUMENT, PLEASE READ CAREFULLY.
Please note, this information is kept confidential and will not affect the youth's ability to participate in YVC programming. It is collected for anonymous grant reporting and program improvement purposes only.
ALL VOLUNTEERS MUST SUBMIT A WAIVER TO BE ELIGIBLE TO PARTICIPATE IN YVC PROGRAMS. IF YOU HAVE REGISTERED MORE THAN ONE VOLUNTEER YOU MUST SUBMIT A WAIVER FORM FOR EACH VOLUNTEER.
Indicates required field
Youth Volunteer Name
Prefer to Self-Describe
If you chose Prefer to Self-Describe and would like to specify please do so below
Date of Birth (MM/DD/YYYY)
What projects did you sign up for?
Boys and Girls Club
Legend Senior Living
Topeka Community Cycle (Topeka Housing Authority)
Prefer not to answer
Prefer to specify
You may specify here
How did you hear about Youth Volunteer Corps?
*If you chose Other please specify here
Why are you/your youth volunteering?
A free t-shirt is included with registration. Please choose what t-shirt size you would like below
Choose your size
Parent/Legal Guardian Information:
Parent/Guardian Phone Number
Emergency Contact #1 (if we cannot reach you)
Emergency Contact #1 Number
Emergency Contact #2 (if we cannot reach #1)
Emergency Contact #2 Number
Health Care Provider/Family Physician
Health Care Provider/Family Physician Number
Does your child have any allergies?
If you chose Yes please explain
Is your child currently under medical care?
If you chose Yes please explain
Please list any mental or physical condition(s) your child has that we should be aware of and any medication they are taking
Please provide any additional information necessary for program directors to provide a safe experience for your youth volunteer (For example: food allergies, who can/cannot provide transportation to youth, etc.)
If the youth named above meets any of the following criteria, check this box
My child meets one or more of the following criteria
This information assists us in receiving funding to cover scholarships. This information is kept CONFIDENTIAL.
Qualifies for free or reduced school lunch, or enrolled in a school where the majority of students are eligible for free or reduced lunch.
Completing court-ordered service or is a former juvenile offender
Living with a disability
Not currently enrolled in school
At risk to leave high school without graduating
In or aging out of foster care
Has limited English proficiency
Homeless or has run away from home
I understand that adult supervisors will accompany my child on all projects and activities. I also understand that the supervisors may be volunteers and that the project or activity will involve the normal level of risk associated with such a project or activity. I agree that this form shall waive any rights, claims of responsibility or liability, or cause of action resulting from personal injury to my child in the YVC program and agree to indemnify the partner agency and its employees or representatives from any such claims.
Medical Care Authorization:
At any time due to such circumstances as accident or sudden illness I hereby give permission for emergency medical treatment to be obtained for my child. I understand that a YVC representative or the partner agency will call me prior to leaving or upon arrival at the emergency destination, and that I will be responsible for all related expenses incurred (i.e. ambulance or taxi costs, etc.).
In the event my child is photographed or filmed for promotional purposes while participating in a YVC project, the photo or video may be used by YVC or any of its related agencies for promotional purposes. I authorize YVC and/or partner agency staff to transport my child in their vehicles if needed.
Parent/Legal Guardian Responsibility:
I will inform YVC of any special need or condition my child has. I understand withholding this information is unfair to my child and to the YVC leader entrusted with my child's safety. I will be punctual when dropping off/picking up my child from projects, both for his/her safety and as a courtesy to YVC and its partner agencies. I understand that violating these policies may lead to my child's exclusion from YVC programs.
Youth volunteer agrees:
To be on time and work all scheduled project hours OR notify YVC in advance if you cannot.
To maintain a positive attitude and show respect to everyone at the project.
To attend any required orientation and training and to participate in all project activities, including games.
To abstain from profanity, drugs, tobacco, alcohol, sexual activity or violence of any form on projects.
To keep all personal electronic devices off and out of sight during YVC activities.
To treat the youth volunteer with respect.
To provide the youth volunteer with appropriate duties that match his or her experience and interests when possible.
To provide trained, screened adult team leaders to guide and assist the youth volunteer on projects.
To provide orientation, training, and evaluation for the youth volunteer as needed.
To recognize the efforts of the youth volunteer and provide confirmation of service hours upon request.
I Agree to the Terms and Conditions
By checking the box you acknowledge that you have read and understand this waiver, agree to its provisions, affirm that you are the parent/legal guardian of the child named above, and verify all the information you have given is correct.
Proudly powered by
What is YVC?