Volunteer Application Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Volunteer Applicant Name *Date of birth *Email *Phone *XXX-XXX-XXXXStreet Address *City, State, Zip Code *Occupation *EmployerIn which of the following would you like to participate? (Check one or more) *Ride Leader/MentorRide with usBring a mealSetup/TakedownOtherPrevious Volunteer ExperienceList any physical disabilities or limitationsDo you have children in the program? *YesNoDo you have a valid driver's license? *YesNoHave you ever been convicted of or plead guilty to any crime(s)? *YesNo you Do you If yes, please explain below.Have you ever received deferred adjudication for an offense or otherwise required to register as a Sex Offender under any state or federal statute? *YesNoIf yes, please explain below. Have you ever been refused participation in any youth programs? *YesNoIf yes, please explain below. Do you have any special Certification (i.e. Certified Coach, CPR, Medical, etc.)If so, list aboveRead and Sign this Waiver *I certify that all statements on this application are true and correctI certify that all statements on this Application are true and correct. As condition of volunteering, I give permission for Lifecycles Louisiana to conduct a background check on me, which may include a review of sex offender registries, child abuse and criminal history records. I understand that, if approved, my position is conditional upon the ministry receiving no inappropriate information on my background. I hereby release and agree to hold harmless from liability Lifecycles Louisiana, their officers, employees and volunteers thereof, or any other person or organization that may provide such information. I also understand that, regardless of previous appointments, Lifecycles Louisiana is not obligated to appoint me to a volunteer position. If appointed, I understand that I am subject to suspension by the Director and removal by the Board of Director for violation of Lifecycles policies or principles.Type Your Name Below to Sign this Form *Submit
