JDRF Oklahoma Youth Ambassador Program 2017 Promise Ball 20 th Anniversary Information Packet
Dear Prospective JDRF Youth Ambassador: I am writing to invite you to participate in the 2017 JDRF Youth Ambassador Program for the 20 th Anniversary Promise Ball. This group is made up of type 1 children & youth, 18 and under, who are interested in becoming involved with the volunteer efforts of the promise ball. This group will be involved with JDRF in many ways including volunteering, media appearances, awareness, and advocacy. In addition, the JDRF Youth Ambassador Program will provide social opportunities to the participants to promote friendship, support of each other, and good times! I hope you will choose to participate in the JDRF Youth Ambassador Program for the 2017 Promise Ball 20 th Anniversary. You have the ability to help JDRF in many ways. We need your voice, your participation, and your leadership. Attached you will find a JDRF Youth Ambassador Program application form, as well as photograph and volunteer waivers. Please fill them out and send them back to me at pblalock@jdrf.org, or mail or fax to the office at the address below. 907 S. Detroit Ave. Suite 1006 Tulsa, OK 74120 Fax: 405-481-5823 I am looking forward to working with you for JDRF and our community. Together, we can make a difference! With hope for a cure, Paula Blalock JDRF Development Coordinator
Youth Ambassador Program The JDRF Youth Ambassadors are children with type 1 diabetes (T1D), age 18 and under, who are involved with the educational and volunteer efforts of JDRF Oklahoma. They are the face of JDRF at the Promise Ball. The JDRF Youth Ambassador Program also provides social opportunities to all members to promote friendship, support of each other, and good times! Would you like to work with other kids to spread awareness and help with the fight of T1D? If you are 18 and under and would like to: - Volunteer to support and represent JDRF at the Promise Ball - Socialize with other T1D kids or teens - Make a DIFFERENCE!..Then the JDRF Youth Ambassador program is for you! There are many exciting and meaningful ways that kids and teens of all ages can participate! Parent support is typically necessary; however, child/youth involvement is a must! What to look forward to as a JDRF Youth Ambassador: Volunteering - JDRF Promise Ball Media Appearances Promoting T1D Awareness Government Advocacy
Youth Ambassador Program Application Child s Name: Birthday: Date Diagnosed: Parent(s) Name: Mailing Address: City: St: Zip: Child s Cell: Home Phone: Parent(s) Cell: Parent s Email: Child s Email: By signing this form you are giving your child permission to participate in the JDRF Youth Ambassador program for the 2017 Promise Ball 20 th Anniversary and agree to the following: Volunteer at the 2017 Promise Ball if/where needed Write thank you letters to donors after the event Secure a youth ambassador basket valued at $150.00 (or more) due on or before Monday, May 8, 2017. Please see attached list for basket theme ideas. Email pblalock@jdrf.org if you have questions or need help Parent Signature Date Please return your completed application & waivers by: JDRF Fax: 918-481-5823 / Email: pblalock@jdrf.org Mail: 907 S. Detroit Ave., Suite 1006, Tulsa, OK 74120
Volunteer Waiver In consideration of being permitted to serve as a volunteer, I hereby waive, release and give up any and all claims and causes of action that I, my heirs, guardians or legal representatives, now have or may have in the future against JDRF or any of its officers, board members, directors, employees, agents, representatives, affiliates, chapters, successors, assigns, donors or other volunteers, for injury or damage of any sort whatsoever arising out of or in any way related to my service as a volunteer. 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 volunteer. I understand and assume any risks of engaging in volunteer work such as, or similar to, that which is described in the attached Volunteer Position Description. I also understand and expressly agree that the above waiver and release of this Volunteer Waiver extends to and includes claims of every nature and kind, whether known or unknown, suspected or unsuspected. Further, I expressly waive any and all rights granted under California Civil Code (CCC) 1542 or any similar law, regulation or policy of any state or territory of the United States. CCC 1542 reads as follows: A general release does not extend to claims which the creditor does not know or suspect in his favor at the time of executing the release, which if known by him must have materially affected his settlement with the debtor. The waiver and release shall be enforceable to the fullest extent permitted by law. This Waiver may be terminated by either you or JDRF, with or without cause, at any time by notice to the other party. Your agreement to the waiver and release provisions, however, survive and continue to be in effect after termination of this Waiver with respect to any matters, circumstances or events occurring prior to the termination of this Waiver or in any way related to your volunteer service under this Waiver. I acknowledge that I have read and understand this Volunteer Waiver; that I have been given a reasonable amount of time to review this Volunteer Waiver; and that I voluntarily agree to the terms above. JDRF Representative (Please Print Name and Title) _ Volunteer Name (Please Print) JDRF Representative (Signature) Volunteer Name (Signature) IF VOLUNTEER IS A MINOR, BOTH PARENTS WITH LEGAL CUSTODY OR MINOR S LEGAL GUARDIAN MUST SIGN IN ADDITION TO THE MINOR VOLUNTEER. By signing this Volunteer Agreement, parent or guardian agrees to the waiver of claims and indemnification of JDRF set forth above, on behalf of the volunteer 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 Volunteer s service. Parent or guardian requests that JDRF permits the above minor child to participate in volunteer service. Parent/Guardian (For Volunteers Under Age 18) Parent/Guardian (For Volunteers Under Age 18)
JDRF Oklahoma 907 S. Detroit Ave., Suite 1006 Tulsa, OK 74120 p: 918-481-5807 f: 918-481-5823 http://tulsa.jdrf.org VIDEO/PHOTOGRAPH RELEASE FORM I, (please print) as the parent or guardian of who is not of legal age, do hereby consent and authorize JDRF to use and reproduce the video and or photographs taken of him or her and circulate same for promotion of JDRF events and purposes. I further release the JDRF from any and all claims of damages for libel, slander, invasion of the rights of privacy, or any other claims based on, arising from, or connected with the use of said video and photographs. No representations have been made to me. Parent or Guardian Signature Date Address: Telephone #: Witness Signature Date