Privacy Policy

This statement describes the policies and practices of the Young Men's Christian Association of Metropolitan Washington ("YMCA") regarding the collection and use of your personal information from your visit to our website and submission. The YMCA is a nonprofit organization whose principal mission is to foster the spiritual, mental and physical development of individuals, families and communities according to the ideals of inclusiveness, equality and mutual respect for all. The YMCA is committed to maintaining the privacy of visitors to our website and users of our Internet services. Please review our standards below.

Information Collected

General Use

The YMCA may collect and store information about you on an anonymous and aggregate basis. This information is used only to measure website traffic and activity so that we can continue to improve the site and provide the best services possible to our community. The YMCA is the sole owner of the information collected on this site. We will not sell, share, or rent this information to other businesses or individuals, and we do not track individual user's visits to our websites.

Security

The YMCA takes every precaution to protect our website users' information. When you use the YMCA's websites to register for events, purchase products or services, or join groups, the YMCA collects information necessary to process the transaction. This may include your name, address, telephone and fax numbers, e-mail addresses, vaccine status, and credit card or other payment information. This information is encrypted to insure that your private information is transmitted in a secure fashion. If we collect information for payment purposes, it is stored and used by us or by others we contract with to process orders for that transaction only. The YMCA makes no representations or guarantees regarding unlawful or inappropriate use of information entered in our websites by third parties.

Use of Information

The YMCA will sometimes use your e-mail address, address, fax number or other information to confirm a transaction, verify your identity, send you general information such as newsletters, or for similar purposes, either directly or through others we contract with. The YMCA will not disclose any information to third parties for any other purpose, and we will not sell mailing lists. In some cases, you will be given the choice not to have your information used for some of these purposes. In those cases, you will see information on how to make that choice.

Copyright

All text and graphic material displayed on this website is the exclusive, copyrighted property of the YMCA. Pass-along usage of any of our materials for any purpose other than the direct support of the YMCA is prohibited.

Contact

If you have any questions about this Privacy Policy, the privacy and security at our website, or our copyright restrictions, please contact the webmaster.

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YMCA DC Youth & Government Volunteer Intake and Consent Form

Thank you for volunteering with the YMCA DC Youth & Government Program! Our volunteers are #1 resource; without you, we wouldn't be able to provide this extraordinary program to our teens. This form helps us ensure we are keeping you and students safe. If you are have any issues, please email Program Director Lindsey Pullum at lindsey.pullum@ymcadc.org


Review Privacy Policy

YMCA OF METROPOLITAN WASHINGTON EMPLOYMENT AND VOLUNTEER CONSENT FORM

In connection with my application for employment and/or continued employment, I understand that consumer reports or investigative consumer reports which may contain public record information may be requested or made on me, including my creditworthiness or similar characteristics, employment and education verifications, social security verification, criminal and civil history, sex offender registry, personal interviews, DMV records, any other public records and any other information bearing on my credit standing, credit capacity, character, general reputation, personal characteristics or mode of living, and trustworthiness. These reports may include employment and credit experience along with reasons for termination of past employment.

I hereby authorize and consent to the Young Men’s Christian Association of Metropolitan Washington’s (the YMCA”) procurement of consumer and/or investigative consumer reports. I further authorize ongoing procurement of the above- mentioned reports at any time during my employment.

I understand that, pursuant to the federal Fair Credit Reporting Act, the YMCA will provide me with a copy of any such report if the information contained in such report is, in any way, to be used in making a decision regarding my fitness for employment with the YMCA. I further understand that such report will be made available to me prior to any such decision being made, along with the name and address of the reporting agency that produced the report. I have the right to make a request of Employment Screening Alliance, Inc. (or such other credit reporting agency that produced the report), upon proper identification and the payment of any authorized fees, for the information in its files on me at the time of my request.

I hereby release Employment Screening Alliance, Inc. (or such other credit reporting agency that produced the report), the YMCA, and any and all persons, business entities and governmental agencies, whether public or private, from any and all liability, claims and/or demands, of whatever kind, to me, my heirs, or others making such claim or demand on my behalf, for procuring, selling, providing, brokering, and/or assisting with the compilation or preparation of the consumer report and/or investigative consumer report hereby authorized. 

December 9, 2022

YMCA Media Waiver and Code of Conduct

ACKNOWLEDGEMENT

I expressly acknowledge that there are certain dangers, risks, illnesses and personal injuries inherent in participating in the YMCA’s programs, events, classes, and/or other activities, which may result from unavoidable accidents or injuries, athletic activities, sports programs/classes, the use of any equipment, exercise, or other activities or from my or my minor child(ren)’s or ward(s)’ physical condition. I understand that the YMCA and its employees, agents, counselors, teachers, trainers, representatives, successors and assigns assume no responsibility for loss, damage, illness or injury to person or property that I or my minor child(ren) or ward(s), if applicable, may sustain as a result of my or their physical condition or resulting from my or their participation in any activities, programs, events, classes, the use or non-use of any equipment, exercise, horseback riding, archery, field trips, waterfront and pool activities, canoeing/boating, campfires, hiking, high ropes and other challenge courses, or any other activities, classes, events, or programs at and/or sponsored by the YMCA. I expressly acknowledge, on behalf of myself and my minor child(ren) and ward(s), heirs and executors, that I voluntarily assume the sole risk for any and all dangers, illnesses and personal injuries that may result from my or my minor child(ren)’s or ward(s)’ participation in any events/activities/programs/classes while at the YMCA and/or sponsored by the YMCA.

I also acknowledge that the YMCA often uses photographs, videotapes, television programs, motion pictures, tape recordings, or other similar media for promotional purposes. I hereby consent to the use of my and/or my minor child(ren)’s or ward(s)’ name(s) and/or likeness(es) in such materials to be exhibited and used for advertising, trade purposes, solicitation of patronage, promotional purposes, or other similar purposes, even if my and/or my minor child(ren)’s or ward(s)’ name(s) and/or likeness(es) are an integral part of such photograph, videotape, television program, motion picture, tape recording, or other similar media.

RELEASE

In consideration of the YMCA allowing me and/or my minor child(ren) or ward(s) to attend and/or participate in any programs, events, classes, or other activities at the YMCA and/or sponsored by the YMCA, I hereby, for myself, my minor child(ren) or ward(s), heirs, and executors, waive, release and forever discharge the YMCA and its employees, agents, counselors, teachers, trainers, representatives, successors and assigns, from and against any and all rights and claims for any loss, damage, illness or injuries to person or property sustained as a result of my attendance and/or participation in any such programs, events, classes, and other activities, whether or not such loss, damage or injury results from the negligence of the YMCA and its employees, agents, or representatives or from some other cause. My agreement to release the YMCA does not include any loss, damage or injury that results from the YMCA's gross negligence or willful, wanton, or reckless misconduct.

I further waive any and all rights to inspect or approve the photograph, videotape, television program, motion picture, tape recording or other use of my and/or my minor child(ren)’s or ward(s)’ name(s) and/or likeness(es), including any written article, script, caption or other writing that may accompany such use of my and/or my minor child(ren)’s or ward(s)’ name(s) and/or likeness(es). I hereby, for myself, my minor child(ren) or ward(s), heirs, and executors, waive, release and forever discharge the YMCA and its employees, agents, counselors, teachers, trainers, representatives, successors and assigns, from and against any and all liability, claims, losses, costs, expenses or damages for libel, slander, invasion of privacy, conversion, defamation, appropriation of likeness or any other claim based on the use of my and/or my minor child(ren)’s or ward(s)’ name(s) and/or likeness(es) in any such materials.

INDEMNIFICATION

I hereby represent and warrant to the YMCA that I have the authority to execute this Participant Waiver Form on behalf of myself and/or on behalf of my minor child(ren) or ward(s) as parent, guardian and/or next friend, if applicable. In the event of any misrepresentation or breach of the foregoing warranty by me, or in the event that I, my minor child(ren) or ward(s), or any other person nevertheless asserts any claim against the YMCA arising out of my or my minor child(ren)’s or ward(s)’ participation in any program, event, class or other activity as set forth herein, I agree to indemnify, hold harmless and defend the YMCA from and against any and all liability, claims, losses, costs, expenses or damages resulting therefrom, including, but not limited to, claims of loss, damage, illness or injury to person or property whether or not such loss, damage, illness or injury results from the negligence of the YMCA or from some other cause.

ACCEPTANCE

I expressly acknowledge and agree to the terms and conditions set forth on this Participant Waiver Form.

December 9, 2022

YMCA DC YOUTH & GOVERNMENT PROGRAM EXPECTATIONS FOR ADULT PARTICIPANTS

1. Adult program participants are expected to abide by the Code of Conduct for Students and be willing to enforce it at all times when attending a Youth & Government activity.

2. Adult program participants are expected to report all violations of the Code of Conduct to the Program Director immediately. In the event that the violation is minor in nature and if it is after 1:00 AM, they may report it to the Program Director the next morning.

3. Adult program participants are expected to be present in the program area assigned to them at all designated times.

4. Adult program participants are expected to have another adult present whenever they:


a. patrol the hallways before and after curfew;

b. need to talk with a student in a private setting; or

c. transport a single student to a Youth & Government program activity, to a doctor, or to a hospital.


5. Adult program participants are expected to have at least two students present if I am transporting students to a Youth & Government program activity and there is no other adult traveling with them.

6. Adult program participants are expected to read all notes that have been given to them prior to permitting them to be passed on to others.

7. Adult program participants are expected not to share hotel accommodations with students during a Youth & Government program activity.

8. Adult program participants are expected to have all of their students sign code of conducts and participant waivers before they permit any student to travel to any Youth & Government activity.

9. Adult program participants are expected to conform to the core values of the YMCA and this program.

10. Adult program participants are expected to have completed a thorough background check. In any case, agree that they have never committed a crime involving a minor or sexual offense.

11. Members’ health and safety are very important to the YMCA and therefore we ask you respectfully refrain from the use of incense, tobacco products and the use of or possession of alcoholic beverages or non-prescription drugs. Possession or use of a firearm or other instrument that could be used as a weapon is forbidden at any Y&G function.

I have reviewed these expectations. I understand that the Program Director may terminate my affiliation with the program if I am found to be in violation of any of these expectations.

December 9, 2022

First Volunteer's Name

First Name*

Middle Name

Last Name*

Phone*
First Volunteer's Date of Birth*
First Volunteer's Experience with Y&G

Describe your experience with Youth & Government. Are you an alum of the Y&G program in DC? If so, what was your role and/or delegation? Are you an alum from another state’s program? What was your role there? If you have no previous experience, please write “N/A”. *

Working with children requires all volunteers have a background check conducted. Provide your Social Security Number. This information will not be shared. *
First Volunteer's Signature*
Second Volunteer's Name

First Name*

Middle Name

Last Name*

Phone*
Second Volunteer's Date of Birth*
Second Volunteer's Experience with Y&G

Describe your experience with Youth & Government. Are you an alum of the Y&G program in DC? If so, what was your role and/or delegation? Are you an alum from another state’s program? What was your role there? If you have no previous experience, please write “N/A”. *

Working with children requires all volunteers have a background check conducted. Provide your Social Security Number. This information will not be shared. *
Third Volunteer's Name

First Name*

Middle Name

Last Name*

Phone*
Third Volunteer's Date of Birth*
Third Volunteer's Experience with Y&G

Describe your experience with Youth & Government. Are you an alum of the Y&G program in DC? If so, what was your role and/or delegation? Are you an alum from another state’s program? What was your role there? If you have no previous experience, please write “N/A”. *

Working with children requires all volunteers have a background check conducted. Provide your Social Security Number. This information will not be shared. *
Fourth Volunteer's Name

First Name*

Middle Name

Last Name*

Phone*
Fourth Volunteer's Date of Birth*
Fourth Volunteer's Experience with Y&G

Describe your experience with Youth & Government. Are you an alum of the Y&G program in DC? If so, what was your role and/or delegation? Are you an alum from another state’s program? What was your role there? If you have no previous experience, please write “N/A”. *

Working with children requires all volunteers have a background check conducted. Provide your Social Security Number. This information will not be shared. *
Fifth Volunteer's Name

First Name*

Middle Name

Last Name*

Phone*
Fifth Volunteer's Date of Birth*
Fifth Volunteer's Experience with Y&G

Describe your experience with Youth & Government. Are you an alum of the Y&G program in DC? If so, what was your role and/or delegation? Are you an alum from another state’s program? What was your role there? If you have no previous experience, please write “N/A”. *

Working with children requires all volunteers have a background check conducted. Provide your Social Security Number. This information will not be shared. *
Sixth Volunteer's Name

First Name*

Middle Name

Last Name*

Phone*
Sixth Volunteer's Date of Birth*
Sixth Volunteer's Experience with Y&G

Describe your experience with Youth & Government. Are you an alum of the Y&G program in DC? If so, what was your role and/or delegation? Are you an alum from another state’s program? What was your role there? If you have no previous experience, please write “N/A”. *

Working with children requires all volunteers have a background check conducted. Provide your Social Security Number. This information will not be shared. *
Seventh Volunteer's Name

First Name*

Middle Name

Last Name*

Phone*
Seventh Volunteer's Date of Birth*
Seventh Volunteer's Experience with Y&G

Describe your experience with Youth & Government. Are you an alum of the Y&G program in DC? If so, what was your role and/or delegation? Are you an alum from another state’s program? What was your role there? If you have no previous experience, please write “N/A”. *

Working with children requires all volunteers have a background check conducted. Provide your Social Security Number. This information will not be shared. *
Eighth Volunteer's Name

First Name*

Middle Name

Last Name*

Phone*
Eighth Volunteer's Date of Birth*
Eighth Volunteer's Experience with Y&G

Describe your experience with Youth & Government. Are you an alum of the Y&G program in DC? If so, what was your role and/or delegation? Are you an alum from another state’s program? What was your role there? If you have no previous experience, please write “N/A”. *

Working with children requires all volunteers have a background check conducted. Provide your Social Security Number. This information will not be shared. *
Ninth Volunteer's Name

First Name*

Middle Name

Last Name*

Phone*
Ninth Volunteer's Date of Birth*
Ninth Volunteer's Experience with Y&G

Describe your experience with Youth & Government. Are you an alum of the Y&G program in DC? If so, what was your role and/or delegation? Are you an alum from another state’s program? What was your role there? If you have no previous experience, please write “N/A”. *

Working with children requires all volunteers have a background check conducted. Provide your Social Security Number. This information will not be shared. *
Tenth Volunteer's Name

First Name*

Middle Name

Last Name*

Phone*
Tenth Volunteer's Date of Birth*
Tenth Volunteer's Experience with Y&G

Describe your experience with Youth & Government. Are you an alum of the Y&G program in DC? If so, what was your role and/or delegation? Are you an alum from another state’s program? What was your role there? If you have no previous experience, please write “N/A”. *

Working with children requires all volunteers have a background check conducted. Provide your Social Security Number. This information will not be shared. *
Parent or Guardian's Email Address

Email*

Confirm Email*
Parent or Guardian's Driver's License / ID Card

Driver's License / ID Card Number*

Issuing State*
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
YMCA Volunteer Vaccine Card
  
Upload a copy of your Vaccine Card indicating your two-shots and booster. *
Valid file types: JPG, GIF, PNG, and PDF
Volunteer's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Experience with Y&G

Describe your experience with Youth & Government. Are you an alum of the Y&G program in DC? If so, what was your role and/or delegation? Are you an alum from another state’s program? What was your role there? If you have no previous experience, please write “N/A”. *

Working with children requires all volunteers have a background check conducted. Provide your Social Security Number. This information will not be shared. *
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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