JDRF Hampton Roads Youth Ambassador Program Description The Youth Ambassador Program offers youth opportunities for personal growth and development of leadership skills, while creating awareness for JDRF and supporting fundraising efforts. Youth Ambassadors will be selected to represent JDRF in their local communities and help further JDRF s mission of creating a world without T1D. Child participation is a must the ambassador role will be fulfilled by the youth, but they will need a supportive family and network to help them achieve their goals. Youth Ambassador Requirements: Must have T1D (and be living with T1D for at least 6 months) Must have previous involvement with chapter (Walk team, attend outreach events, volunteer in the office or at events) Age 6 20 years Have a positive outlook on life and diabetes Be willing and comfortable sharing his/her personal story in front of small and large group Complete volunteer service at JDRF and community outreach events throughout the one year term, a minimum of 3 events and 6 stewardship opportunities are required Participate in a chapter fundraising program or create their own fundraising event Passion for the JDRF mission Be committed and present throughout the one year term Must attend Youth Ambassador Training session and Youth Ambassador End of Year Party Activity Requirements: Event Participation (3 required) One Walk as a volunteer and as a fundraising Walk team raising over $500. Outreach Events attend/volunteer at events throughout the year. Gala- volunteer with event set up, night of, and clean up. Contribute to the Youth Ambassador silent auction package with at least 1 item valued at $125 or more. Ride to Cure Diabetes participate in the Ride to Cure Diabetes or help with making posters for the Ride team to decorate their doors on Ride Weekend. Stewardship Participation (6 required) Corporate Partners Visits- visit an assigned list of corporate partners to thank them for their partnership with JDRF. Call-a-thons- help out at various call-a-thons throughout the year to help promote events, advocacy news, and further steward our donors and families. Thank you s thanking donors via phone calls and/or letters.
Additional Opportunities: event kick-off and post-celebrations; speaking opportunities at corporate or school events; Advocacy meetings; tabling opportunities at JDRF or community events; cause marketing stewardship; media interviews; in-office volunteering as needed. Youth Ambassador Roles & Responsibilities at Chapter Events: Public speaking share your personal story Welcome and greet event guests Staff JDRF information tables Help with event set-up Speak with local media reporters about JDRF and share your T1D story Assist with volunteer work at chapter office For more information, email hamptonroads@jdrf.org or contact Anna at 757-355-5460. JDRF Hampton Roads Youth Ambassador Application Applications are due July 15. All applicants will be notified of their application result by August 15 th. If selected, mandatory training will take place in August at the JDRF Office. Please complete all information on the following pages, including the submission of an about me video. Materials should be emailed to hamptonroads@jdrf.org by July 15, 2018. Incomplete applications will not be considered. Applicant Information First Name: Last Name: Date of Birth: Age: Date of Diagnosis: Street Address: City: State: Zip: Preferred Phone Number: circle: cell or home Email: School: 2018-19 Grade: Parent(s) Name(s): Which of the following JDRF Hampton Roads events or programs have you or your family participated in or attended: One Walk If yes, please list your team name Ride to Cure Diabetes If yes, please list Ride location Gala Research Spotlight One Walk Kick-Off: Progress to Type None Event
Advocacy Please circle: Children s Congress, Promise to Remember Me Meetings, Action Alerts Volunteer Activities If yes, which program or event Other Please include detail MANDATORY AMBASSADOR TRAINING I understand that I am required to attend mandatory Youth Ambassador Training in August at the JDRF Office, located at 291 Independence Boulevard #517, Virginia Beach. Initial Here: PARENTS/GUARADIANS COMMITMENT I understand this time commitment will require parental/guardian resources of time, transportation, supervision and support. Initial Here: Applicant Short Answer Questions For the youth applicant to answer in his/her own words. Parents can assist with responses, but they should be in the child s own words. Submissions can also be attached to the application separately. Please tell us about yourself: Please tell us why you would like to become a JDRF Youth Ambassador and where you would like to make an impact in the community: What would you like people to know about type 1 diabetes?
Please tell us more about you! What activities do you enjoy? Favorite food: Favorite Color: Favorite Movie or Book: Favorite Subject in School: Favorite Place: When I grow up, I want to be: Activities, Clubs, Band or Sports you participate in: Favorite JDRF Event: Availability Rank the days of the week in order of the best time for you to attend events. Please mark 1 as most available and 7 as least available. Afternoon: 3-6pm Monday Tuesday Wednesday Thursday Friday Saturday Sunday Evening: 7-9pm Monday Tuesday Wednesday Thursday Friday Saturday Sunday Youth Ambassador Interview Video As a JDRF Hampton Roads Youth Ambassador, you will have the opportunity and responsibility to represent JDRF at several events. Duties will vary, and can include sharing your story in front of an audience, greeting guests at events and staffing the JDRF information booth at events. Please record a 1 minute video using a smartphone or other device and send via.mp4 or.mov file to hamptonroads@jdrf.org with your application. If you prefer, you can upload your video to YouTube and send the direct link. We want to get to know you, so use this video to talk about whatever is important to you and reflects your personality! Topic ideas could be telling us your T1D story, teaching us how to do something like shooting a basketball or talking about your favorite movie. Be creative! Youth Ambassador Photo Waiver I authorize my child s picture to be used in print, media, online and any publication where the Youth Ambassador Program may be mentioned or advertised. This includes Facebook, JDRF Minnesota Chapter website, YouTube, Youth Ambassador Program materials and other social and/or print media outlet(s) JDRF Minnesota or JDRF chooses. I acknowledge that I have read and understand this Youth Ambassador Photo Waiver; that I have been given a reasonable amount of time to review the Youth Ambassador Waiver; and that I voluntarily agree to the terms above. Applicant/Parent Name Applicant/Parent Signature
Date IF THE YOUTH AMBASSADOR IS A MINOR, EITHER PARENT WITH LEGAL CUSTODY OR MINOR S LEGAL GUARDIAN MUST SIGN. By signing this Youth Ambassador Agreement, parent or guardian agrees to the waiver of claims and indemnification of JDRF set forth above, on behalf of the Youth Ambassador and on behalf of the parent or guardian as to any and all rights or claims that the parent or guardian may have now, or in the future may have, arising out of or in connection with the Youth Ambassador s service. Parent or guardian requests that JDRF permits the above minor child to participate in the JDRF Minnesota Youth Ambassador Program. Parent Name Parent Signature Parent/Guardian for Youth Ambassadors under age 18 Date Youth Ambassador Waiver As a Youth Ambassador for JDRF Hampton Roads, I promise to act in a respectable manner, knowing that my actions and words directly represent the JDRF organization. I agree to indemnify and hold harmless JDRF from any claims, causes of action or liabilities (including costs and expenses) based on or arising from my actions or conduct as a Youth Ambassador. I understand and assume any risks of engaging in volunteer work such as, or similar to, that which is described in the attached Youth Ambassador Program Description. I also understand and expressly agree that the above waiver and release of this Youth Ambassador Waiver extends to and includes claims of every nature and kind, whether known or unknown, suspected or unsuspected. The waiver and release shall be enforceable to the fullest extent permitted by law. I acknowledge that I have read and understand this Youth Ambassador Waiver; that I have been given a reasonable amount of time to review this Youth Ambassador Waiver; and that I voluntarily agree to the terms above. Applicant Name Applicant Signature Date IF THE YOUTH AMBASSADOR IS A MINOR, EITHER PARENT WITH LEGAL CUSTODY OR MINOR S LEGAL GUARDIAN MUST SIGN. By signing this Youth Ambassador Agreement, parent or guardian agrees to the waiver of claims and indemnification of JDRF set forth above, on behalf of the Youth Ambassador and on behalf of the parent or guardian as to any and all rights or claims that the parent or guardian may have now, or in the future may have, arising out of or in connection with the Youth Ambassador s service. Parent or guardian
requests that JDRF permits the above minor child to participate in the JDRF Hampton Roads Youth Ambassador Program. Parent Name Parent Signature Parent/Guardian for Youth Ambassadors under age 18 Date By signing this form, you are giving your child permission to participate in the Youth Ambassador Program August 2018 August 2019. Finalize Your Application Please return your completed application and video via email to hamptonroads@jdrf.org. Applications are due on July 15, 2018. If you have questions, please contact Anna at 757-355-5460 or email hamptonroads@jdrf.org. Thank you for your application! Good luck!