Youth Volunteer Application

Youth Volunteers!

Red Wiggler Community Farm is a sustainable farm where people with and without intellectual and/or developmental differences come together to work, learn, and grow healthy food. We are always looking for enthusiastic individuals with a passion for our mission to volunteer.

If you are interested in volunteering, please complete the form below. Someone will contact you about your interest in the near future. Thank you again!

Youth Volunteer Application

Today's Date *

First Name *

Last Name *

Email *

Cell Phone *

Parent Phone *

Age *

School *

The following ten items are to be filled out by the Parent/Legal Guardian

Parents'/Legal Guardians' Names *

Emergency Contact Address *

Emergency Contact City *

Emergency Contact State *

Emergency Contact Zip Code *

Emergency Contact Phone Number *

Emergency Contact Secondary Phone Number

Do you want to receive occasional emails from Red Wiggler regarding upcoming events & updates? Please click YES or NO.

Red Wiggler Emails *

Yes No

Do you grant permission for your child to be photographed or videoed for possible inclusion in a Red Wiggler Community Farm publication or other publications for the purpose of promoting Red Wiggler? Please click YES or NO.

Photo Release for Child *

Yes No

PARENT/LEGAL GUARDIANS, PLEASE TYPE IN YOUR NAME AND DATE. THIS IS YOUR ELECTRONIC SIGNATURE FOR THIS YOUTH VOLUNTEER APPLICATION.

Parent/Legal Guardian's Electronic Signature *

YOUTH VOLUNTEER APPLICANTS - No experience is necessary for this position. For our records, have you ever worked in a greenhouse? Including seeding, transplanting, and/or watering?

Greenhouse Experience *

Yes No

Have you ever planted seeds or transplanted?

Planting Experience *

Yes No

Have you ever harvested vegetables? Including bunching greens and/or digging root vegetables?

Harvesting Experience *

Yes No

Have you ever handled vegetables after harvesting, including washing, sorting, and weighing vegetables?

Post Harvesting Experience *

Yes No

Have you ever done field maintenance activities, including weeding, thinning, mulching, or raking?

Field Maintenance Experience *

Yes No

Have you worked or interacted with adults with disabilities?

I/DD Experience *

Yes No

Please list your strengths and limitations as it applies to working cooperatively with others, following instructions and completing tasks independently.

Strengths and Limitations *

Please list your strengths and limitations as it applies to completing physical labor and working outside in different weather conditions for 2-3 hours at a time, with appropriate breaks.

Physical Labor & Working Outside *

Do you require the use of any of the following? Click YES or NO.

Adaptive Equipment *

Yes No

Assistive Communication Device *

Yes No

Crutches, Cane, or Walker *

Yes No

One-On-One Support *

Yes No

Wheelchair *

Yes No

Special Accommodations - Other *

Do you have any of the following?

Allergies *

Yes No

Please list any allergies you may have.

Allergies - List

Seizure History *

Yes No

Sun Sensitivity *

Yes No

Are there any other medical or physical conditions or special needs of the volunteer that Red Wiggler staff should be made aware of?

Medical/Physical Conditions or Special Needs *

Yes No

If yes, please explain.

Medical/Physical Conditions or Special Needs - Notes

Do you need to fulfill a specific requirement for service hours? (Please note: We do not offer volunteer hours for court-mandated service.)

Service Hours *

Yes No

If you need service hours for school, please indicate the number of hours you need.

School Hours

If you need service hours for another purpose, please indicate the purpose and the number of hours needed.

Other Service Hours

If you need to fulfill service hours by a certain date, please indicate date you need them by.

Service Hours: Deadline

I have read and understand the policies and procedures of Red Wiggler Community Farm.

Youth Signature and Date *

Please type in your electronic signature and date.

Parent/Legal Guardian if Under 18 *

I/We, the parent(s) or guardian(s) of this youth volunteer applicant, a minor, do hereby authorize and consent to the above named child serving as a volunteer at Red Wiggler Community Farm and do hereby for myself and my heirs and assigns, waive any and all claims for damages or injuries I (we) may or will have against Red Wiggler Community Farm, or any agent, employee, volunteer or representative of either for any and all injuries or damages suffered said minor while on the premises of, or while participating in any activities of Red Wiggler Community Farm and further agree to indemnify and hold harmless those parties from any claims whatsoever made on behalf of said minor child. I (we) understand that my child named above wishes to be considered for volunteer work and I (we) hereby give permission for them to serve in that capacity, if accepted by the agency. I (we) understand that my child named above will be provided with the necessary training for the safe and responsible performance of his/her duties and will be expected to meet all the requirements of the position, including regular attendance and adherence to agency policies and procedures. I (we) understand that my child will not receive monetary compensation for any services contributed and that the first 10 volunteer hours will be served as a probationary period. Parent/Legal Guardian, please type in your name and date to acknowledge.

Authorization and Consent for Child to Volunteer *

MEDICAL & LIABILITY RELEASE: In the event that an emergency arises while volunteering at Red Wiggler Community Farm requiring medical treatment, I authorize Red Wiggler to select and designate nurses, physicians, and / or surgeons to furnish medical and / or surgical care, and I authorize such surgical care as, in the judgment of a physician and / or surgeon holding a physician’s surgeon certificate issued by the Board of Medical Examiners of the State of Maryland, as may be needed and proper. I absolve Red Wiggler and nurses, physicians, and / or surgeons selected and designated by them, from any and all liability for their acts rendered in good faith. Parent/Legal Guardian If under 18 years of age, please type in your name and date to acknowledge.

Medical Release for Youth Volunteer Application *

INFORMED CONSENT: I recognize and understand that the activities of my volunteer project or projects at Red Wiggler may be hazardous. I hereby expressly and specifically assume responsibility for any injury or harm resulting from these activities and release and discharge Red Wiggler and representatives thereof from any and all liability for property damage, injury, illness, or death resulting from any volunteer activity. Parent/Legal Guardian If under 18 years of age, please type in your name and date to acknowledge.

Informed Consent for Youth Volunteer Application *