WILBUR STREET YOUTH CENTRE

Thank you for your interest in joining our team of volunteers!
Please take time to complete the following questions and our team will be in contact with you soon.

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* 1. Full Name

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* 2. Date of birth

Date

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* 3. Suburb you live in

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* 4. Blue Card Number

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* 5. Expiry Date

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* 6. Do you have a driver's license?

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* 7. If yes, please provide your driver's license number

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* 8. License Type

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* 9. Do you have any other relevant clearances or Licenses (i.e. Certified youth worker (or similar), NDIS clearance, QLD Police Clearance)

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* 10. If yes, please provide a list of your relevant clearances and/or Licenses

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* 11. Why do you want to volunteer with REKON YOUTH FOUNDATION?

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* 12. Please provide any skills and interests you have (e.g Djing, painting, singing, guitar player etc)

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* 13. Wilbur Street will need volunteers from Monday to Friday 3pm-9pm and Saturday 9am-5pm, What days are you available to volunteer?

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* 14. Please provide your email address

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* 15. Please provide your mobile number

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* 16. What is your preferred form of contact

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* 17. MEDIA RELEASE AGREEMENT

By completing and submitting this form, you (the "Volunteer") acknowledge and agree to the following terms regarding the use of your responses, images, videos, or any other media submitted in connection with REKON Youth Programs:

  • Grant of Permission: You grant REKON Youth Foundation, its affiliates, agents, and assigns the right to use, reproduce, distribute, and display your survey responses, photos, videos, and/or other content submitted in any media (whether now known or later developed), without any further consent, notification, or compensation to you.
  • Use of Media: The media may be used for promotional, educational, or commercial purposes, including but not limited to publications, websites, social media, presentations, and other marketing materials.
  • No Compensation: You acknowledge that you will not receive any compensation, monetary or otherwise, for the use of your survey responses, images, videos, or other content.
  • Rights of Use: You represent that you have the legal right to grant these permissions, and that your responses or submitted media do not infringe on the intellectual property or privacy rights of any third party.
  • Waiver of Liability: You agree to release and hold harmless REKON Youth Foundation, its directors, officers, employees, and agents from any claims, damages, or liabilities arising out of the use of your responses or submitted media as outlined in this agreement.
  • Consent Confirmation: By submitting this form, you confirm that you have read, understood, and agreed to the terms of this Media Release Agreement.

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* 18. RISK WAIVER AND AGREEMENT

By registering as a volunteer, I acknowledge and understand that participation involves certain inherent risks, including the possibility of injury or harm. I agree to assume all risks associated with my participation.

I hereby release and hold harmless REKON Youth Foundation, its staff, and agents from any liability for any injury, accident, or damage that may occur as a result of participation. In case of emergency, I authorise the staff to seek medical treatment if necessary, and I accept full responsibility for any medical expenses incurred.

By checking the box below and submitting this registration, I confirm that I have read and understood this waiver and agree to its terms.

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