Volunteer & Student Application

Contact Information

Country*
State / Province*
Address*
City*
*
*
*
*
*
*
Email*
Confirm Email*
Phone*

Program Interest

For more information on each program, please view the various "Job Descriptions" for volunteers as listed on our website under the "Volunteers" tab.

Please check all that apply.

Which Program(s) Are You Interested In Being A Part Of?*
  • Weekend Respite
  • Adult Day Program
  • Teen Night
  • Saturday Camp
  • Stay and Play
  • Summer Camp
  • Horseback Riding
  • Special Events

Emergency Information

Health Card Number*
Doctors Name*
Docotors Phone Number*
Emergency Contact Name*
Emergency Contact Phone Number*
Emergency Contact Relationship*

Personal Information

Volunteers Availability*
  • Sunday
  • Monday
  • Tuesday
  • Wednesday
  • Thursday
  • Friday
  • Saturday
  • mornings
  • afternoons
  • evenings
  • full days
  • as needed
How Did YOu Hear About Red Roof Retreat?*
Previous/Present Volunteer Experience*
Personal skills/training/hobbies/interests*
Why Do You Want To Volunteer At Red Roof Retreat?*

Placement Information

If "yes", please continue below.

If "no", please skip this section and continue to "References".

School Name
Program Name
Placement Supervisor Name
Number of Hours Needed
Date Hours Need To Be Completed By

References

Reference Name 1*
Reference Phone Number 1*
Reference Relationship 1*
Reference Name 2*
Reference Number 2*
Reference Relationship 2*

Acknowledgement and Agreement

Acknowledgement and Agreement:

 

During your volunteer role/student placement at Red Roof Retreat, you will be working with a variety of individuals with special needs. Confidentiality is of utmost importance.

 

Many of them have cognitive, emotional, physical, medical and/or behavioural issues. Unexpected or aggressive behaviours could include hitting, biting, resistance, running away etc.

 

You will be provided with a brief orientation on your first day of volunteering/student placement (check with the Volunteer Coordinator for times/details) This orientation in no way can cover all of the circumstances that could arise while working at Red Roof Retreat, however, it will provide a framework of what to expect.

 

You may be assigned an individual to be your “buddy” for your visit and you may be responsible for them and may need to make sure they are always within sight and within “arms length”, and participating in activities. At other times you may be given a task to do related to the program you are in.

 

Our staff are there to support you and give you guidance on how to work with the individuals. Please ask for assistance, or direct any questions you have to them as soon as they arise.

 

You WILL NOT be responsible for any individuals personal care or medications. You will be part of a group, and WILL NEVER be left alone with an individual. You MUST NEVER leave an individual alone.

 

No cell phones are permitted during program time. They can be placed in a locked cupboard. If you feel someone needs to get a hold of you for emergencies, please give them your supervisor’s phone number and they will relay any messages.

 

You will need to consider this volunteer/student placement seriously, much like a job. You will need to be on time and prepared to work. You must report directly to the Program Supervisor for any changes in attendance, if there is a concern about your “buddy”, or if you witness any unusual occurrence.

 

You must bring a swimsuit and be prepared to swim with your “buddy” each day. You must also bring a lunch and plenty of water.

 

Please check your program hours and report in at the correct time. Please sign out when leaving.

 

Once you begin your volunteer role/student placement, please ask for your Program Supervisor’s phone number in case you need to get a hold of them in an emergency .

 

 

By clicking "submit" below, you are agreeing that you have read and understood the above application.

By clicking "submit", you confirm that you are 16 years of age or older and agree to all of the terms and conditions that may be listed on this Volunteer/Student Placement Application form. You also confirm that you have read and understand all job requirements as listed on the ‘Volunteer/Student Placement Job Description’ pertaining to your program of interest at Red Roof Retreat. Red Roof Retreat reserves the right to accept volunteers into any program at the discretion of the Volunteer Coordinator and/or Executive Director.

Waivers

By clicking "submit" below, you agree that you have read, understand and agree to the following:

 

Declaration of Confidentiality

I have been made aware of the confidential nature of information concerning participants, staff volunteers or other types of confidential information. Whether or not such confidential information may be available to me in the normal performance of my duties or occasionally and inadvertently, the confidentiality will be respected.

I will exercise all reasonable care and caution in protecting printed or written confidential information from casual observation, unauthorized perusal or other abuse.

I understand that taking photographs of the participants and their activities is not permitted unless authorized by a Red Roof Retreat designate.

I understand the confidential information which shall be disclosed to me or which may come to my knowledge may not be divulged within or outside of Red Roof Retreat unless required in the performance of my normal duties or expressly authorized by a Red Roof Retreat designate.

I will take particular care not to mention participants’ names outside of my employment/volunteer/student experience.

I will not take any pictures and/or videos of any participants while volunteering.

 

Memorandum of Understanding

I herewith waive any claim against Red Roof Retreat and/or its staff which may arise from any physical injury to myself or damage to my property incurred during my involvement with Red Roof Retreat and/or while fulfilling duties on behalf of Red Roof Retreat. Further, I have read and agree with Red Roof Retreat’s Code of Confidentiality.

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