Volunteer: Application & Sign Up Form

Volunteer Application

Step 1 of 3

Are you a new volunteer?

Email *

Salutation

Name *

First

Last

Gender

Race *

Ethnicity *

Birthdate *

T-shirt Size

Mailing Address *

Address Line 1

Address Line 2

City

State

Zip Code

Mobile Phone *

Alternative Email

(if you provided a school or organization email, please consider providing us an alternative email)

Primary Affiliation *

(Partnering Agencies Only)

Employer or School

Title

Primary Emergency Contact *

Primary Relationship *

Primary Emergency Contact Phone *

Do you have any medical conditions or physical limitations that we could be aware of? *

Do you have any allergies or dietary restrictions?

(ie. peanut allergy, gluten-free diet, etc.)

Acknowledgement of Volunteer Policies & Application Submission

I acknowledge that I have read, understood, and agree to follow the Bridges' Child Interaction Code of Conduct. *

CHILD INTERACTION CODE OF CONDUCT
1
1. To protect Bridges for End-of-Life volunteers (which includes Bridges’ staff members) and children, at
no time during Bridges’ programing may a volunteer be alone with a single child where the adult
cannot be observed by others.
2. Volunteers will never leave a child unsupervised.
3. Volunteers will respond to children with respect and consideration and treat all children equally
regardless of age, gender, race, religion, sexual identity, or culture.
4. Volunteers will not give gifts or special favors to individual children, or show preferential treatment to
a child or group of children to the exclusion of others.
5. Volunteers will use positive techniques of guidance with children including redirection, positive
reinforcement, and encouragement rather than competition, comparison, and criticism.
6. Volunteers will not date program participants (i.e., children). Volunteers will use appropriate touch
with children including pats on the back or shoulder, side hugs, handshakes, fist bumps, and high fives.
Volunteers will refrain from full frontal hugging, touching of personal areas during a hug or otherwise
(i.e., areas of the body that would be coved by a bathing suit), or patting of the buttocks.
7. Volunteers will respect a child’s right to not be touched in any way that makes the child feel
uncomfortable. A child’s right to say “No” is to be encouraged and respected.
8. Volunteers and children will not occupy the same bed, shower, or bathroom (e.g., at Shannon’s Hope
Camp & school settings). Volunteers will not dress or undress in the presence of children.
9. Volunteers will respectfully supervise children’s private activities and at least 2 volunteers must be
present at all times (e.g., use of restrooms and showering facilities). Volunteers will make sure that the
facilities are not occupied before allowing children to use them. When the facilities accommodates
more than one child at a time (e.g., a multiple stalled bathroom), volunteers will respectfully stand in
the doorway while children are using the facilities to ensure that each child’s safety and dignity is
maintained. If a volunteer is assisting a young child in using the facilities, at least 1 other volunteer
must be present and the doors to the stall or facility must remain open at all times.
10. Volunteers will not use corporal punishment of any kind, abuse children, or knowingly allow a child to
be abused by an adult or peer in any setting. This includes physical, verbal, sexual, and mental abuse as
well as neglect. Any type of abuse or use of corporal punishment will not be tolerated and is cause for
immediate dismissal and a report to the proper authorities will be made.
11. As mandated reporters, volunteers are required to report any suspicion of or witness of child abuse to
the proper authorities to ensure child safety. This includes abuse at the hand of an adult and/or peer in
Bridges For End-of-Life
CHILD INTERACTION CODE OF CONDUCT
2
any setting. To attempt to ensure child safety, if a volunteer witnesses a child being abused, the
volunteer is required to immediately attempt to separate the child and abuser, yelling for help to notify
others in the area. Volunteers are required to immediately notify Bridges’ Program Manager or
Executive Director about the situation so appropriate action can be taken.
12. Volunteers will not expose children to profanity or inappropriate jokes and will not share intimate
details of their personal life with children.
13. Volunteers will not have outside interactions with any program participants (i.e., children) over the
course of child’s programing or after programing has ended. Outside interactions include, but are not
limited to, interactions in person, on the phone, computer, and handheld devices, or through any
social media platform.
14. Volunteers will not transport children without at least one other adult present.
15. During programing and/or in the presence of program participants volunteers will refrain from
intimate displays of affection towards others (e.g., kissing).
16. Volunteers will not use, possess, or be under the influence of alcohol or illegal drugs (including
marijuana) in the presence of children or their parents/guardians during programming hours.
Volunteers will not use tobacco products (including smoking) in the presence of children or their
parents/guardians during programming hours. These behaviors will not be tolerated and is cause for
immediate dismissal.
17. Under no circumstance should volunteers release a child to anyone other than the authorized parent
or legal guardian. Exception: With written consent by the child’s parent or guardian, volunteers may
release a child into the care of another pre-identified adult.
For the safety of Bridges for End-of-Life staff, volunteers and children; any violation of the Bridges’ Child
Interaction: Code of Conduct is strictly prohibited. Any person who believes that this code of conduct has been
broken has a responsibility to report this activity or notify Bridges’ Program Manager or Executive Director
about the situation immediately so action can be taken if necessary.

I understand that Bridges for End-of-Life reserves the rights to accept or reject my application in its sole discretion and that the above statements made in this application are true. I understand that my service will be in accordance with the general personnel policies and guidelines of Bridges. I also authorize Bridges for End-of-Life to conduct a background check for security purposes. Please sign your name below to acknowledge and consent to the information above regarding your application and volunteer status. *

Volunteer Interests & Preferences

Acknowledgement of Volunteer Policies & Application Submission