Thank you for considering the YMCA of Greater St. Petersburg as a place to complete your Internship. All applications are considered on a first-come, first-served basis. Please note: All YMCA Internships are unpaid unless otherwise noted.


Tell us about yourself:


Emergency contact information

Please list a person we may contact in case of emergency.



References

Please list two personal references we can contact on your behalf.



School/University Information


Employment Information

Please list your current or most recent employer.



Availability

Please indicate the days and times you are available to intern.



Q1

Briefly describe the internship goals and objectives established by your institution.



Q2

Why do you want to complete your internship with the YMCA?




Consent to criminal background checks

Each prospective volunteer is to complete the following. Your information is then checked through the Pinellas County Sheriffs Department if the prospective volunteer is a resident of Pinellas County. If the prospective volunteer resides in another county, we submit the information to the Sheriffs Department of that county. By checking the I agree box at the end of this application, I, in accordance with Chapter 85-54, amended to 87-238, Laws of Florida, hereby give the Pinellas County Sheriffs Department permission to search its files and release the information to the YMCA of Greater St. Petersburg, Human Resources. I realize this search is a routine matter for all prospective ongoing service volunteers.


Additionally, my name will be searched in the US Department of Justice's Sex Offender Registry.



Local Criminal Records Check

Have you ever been convicted of a felony, or a misdemeanor for which the record has not been sealed or expunged? (A conviction will not necessarily bar volunteer service. The YMCA may consider the nature, date, and circumstances of the offenses.)

If yes, please provide a date, explanation of offense, location and charge:



eSignature

By clicking I AGREE box below, I agree to criminal background checks, and will comply with the policies and procedures as outlined in the volunteer handbook available on the YGSP's web site (which I have read and downloaded a copy of) and those covered in the online orientation. I attest I am 16 years of age or older. For those age 16 - 17, a parent or guardian must check the I AGREE box and a special underage criminal background check, separate from this application, must be obtained by the youth at their local law enforcement office.


PHOTO RELEASE: I grant permission to the YMCA to use my voice/words, photographs and videotapes taken of me for publication in any form to promote YMCA activities. By checking the 'I Agree' Box (below) I have read and agree to the Photo Release.


AUTHORIZATION FOR EMERGENCY MEDICAL TREATMENT: If I should become ill or injured during a volunteer activity I understand that the YMCA will contact the person I have designated. Should the YMCA be unable to contact the person designated as the emergency contact, they are authorized to arrange for immediate emergency treatment necessary to ensure my health and safety. I accept responsibility for payment of medical services rendered. By checking the 'I Agree' Box (below) I have agree to the authorization for emergency medical treatment.


ASSUMPTION OF RISK: I understand that community service activities may include work that may be hazardous to me. I hereby expressly and specifically assume the risk of injury or harm, or loss or damage to property arising from participation in the volunteer activity. If I require accommodations for special needs or disabilities, I will contact the YMCA, whereby the YMCA, on a case by case basis will review the accommodation request. By checking the 'I Agree' Box (below) I have read and agree to the Assumption of Risk.


VOLUNTARY RELEASE OF THE YMCA OF GREATER ST. PETERSBURG FROM LIABILITY: I am an adult over 18 years of age and I wish to participate in YMCA volunteer activities, or give my child/ward named as the participant above permission to participate in YMCA volunteer activities. I understand that even when every reasonable precaution is taken, accidents can sometimes happen. Therefore, in exchange for the YMCA allowing me to participate in volunteer activities, I understand and expressly acknowledge that I release the YMCA and its staff members from all liability for any injury, loss or damage connected in any way whatsoever to my participation or my child/wards participation in YMCA volunteer activities, whether on or off YMCA premises. I understand that this release includes any claims based on negligence, action or inaction of the YMCA, its staff, directors, members, participants and guests. By checking the 'I Agree' Box (below) I HAVE READ, UNDERSTOOD AND AM VOLUNTARILY AGREEING TO AND ACCEPTING THIS AUTHORIZATION AND RELEASE.


1. The use of illegal drugs, tobacco and/or alcohol is prohibited at any time during any YMCA program, activity or event.


2. The information that I have provided may be verified and I give permission to the YMCA of Greater St. Petersburg to make inquiries from others, which includes criminal background checks, to determine my suitability to act as a YMCA volunteer.


3. In the course of volunteering for the YMCA, I may encounter confidential information and I agree to keep said information in the strictest confidence.


4. The relationship between the YMCA and volunteers is at will and may be terminated at any time for any reason by either party.