BCHD Volunteer Application

Please complete this application form if you are interested in becoming a Beach Cities Health District volunteer. Once you complete the form, click the Submit button at the bottom.

We will then contact you to speak further about your interest. We thank you for wanting to be a part of our team and we look forward to speaking with you soon!

For any immediate questions, contact our team at (310) 374-3426, ext. 246 or volunteers@bchd.org.

Basic Information

Referral Source

How did you hear about us?

Demographic Information

You may optionally provide the following information. It is used only to help us get a better idea of the demographic make-up of our volunteers.

Employer Information

Emergency Contact Information


Please indicate the days and times you are usually available to volunteer.


Below is a very comprehensive list of skill sets that could be utilized in a volunteer capacity. Please check all skills and experience that apply to you!

Volunteer/Work Experience

Volunteer Preference

The following section contains current openings within our volunteer programs. Please check all programs you may be interested in learning more about. For more information regarding these opportunities, click on the opportunity for a description of the program.

Volunteer Agreement

This will serve as an agreement between myself and Beach Cities Health District regarding my volunteer commitment. In exchange for participating in BCHD’s volunteer program, I understand and agree to the following volunteer agreement:

I understand my volunteer responsibilities shall include, but not be limited to:
• Attend BCHD’s volunteer orientation to familiarize myself with BCHD programs and services
• Attend initial training and mandatory ongoing trainings outlined by my volunteer program
• Fulfill agreed upon duties as outlined in the volunteer description as well as other duties or requirements as assigned (e.g., agreed schedule and dress code)
• Keep track of all volunteer hours and turn in a BCHD time sheet by the 5th of each month
• Fill out or turn in any additional paperwork (e.g., process notes, errand authorization forms, copy of car insurance and driver’s license) that is required by my specific volunteer program
• Submit to a background check (if applicable to the program I volunteer with)

I understand that my volunteer status with BCHD is “at will” and that the District or I may terminate my volunteer status with BCHD at any time for any reason.

I have received a copy of the BCHD Anti-Harassment policy. I understand that it contains important information on the District’s anti-harassment policy. I understand and acknowledge that I am expected to read, understand, and adhere to the policy and will familiarize myself with it.
I also understand that I am governed by the contents of this policy and that the District may change, rescind, add, or modify terms of the policies, benefits, or practices described in it (other than the “at will” policies) from time to time in its sole and absolute discretion with or without prior notice. The District will advise employees and volunteers of material changes within a reasonable period of time.

BCHD maintains confidential information of our clients, business operations, employees and overall dealings of the District. BCHD is legally and morally obligated to ensure the protection of such confidential information. Confidential information includes, but is not limited to, such things as client lists, client names, personnel files, financial and marketing data, compensation data, addresses, phone numbers, medical history data and trade secrets.
As a volunteer, you may need to access this information. I agree not to share such information with individuals outside of the District and will disclose such information with other volunteers and employees only when there is a need for such persons to have access to confidential information.

I understand that I must carry automobile liability insurance for any driving I do related to my volunteer assignment(s). My volunteer activities may also expose me to risks of injury, illness, and accidents such as any bodily injuries at the District’s site, inter-action with District personnel, volunteers, client, and vendors. These risks may include, but is not limited to, slips, falls, accidents, exposure to infections, assaults, torts of any kind, and any risks associated with volunteer activities. I hereby agree to fully accept any and all risk of injury, illness and death that may result from my participation in the volunteer program and hereby fully release BCHD from any and all liability or damages for claims I may have relating to my work as a volunteer.

I hereby authorize BCHD to use my image in its publications, including but not limited to the Livewell magazine, brochures, flyers, the Web site, and audiovisual presentations. I understand that this image may be disseminated to print or broadcast news media to publicize services and programs of BCHD and may appear in local, regional, or national publications. I understand that my image becomes the property of BCHD and I waive all rights/privileges associated with this image.
I hereby release BCHD from any liability that may result from the use of my (son/daughter’s) image as part of publicity efforts by BCHD.

I understand that in order to volunteer in programs for children, seniors, or those where the volunteer work does not include direct supervision from a BCHD staff person, I must submit to the following pertaining to my program (which the requirements can be found in my volunteer description):
1. Submit to a background check (18 years or older)
2. Submit to a drug screen
3. Provide proof of current TB test or submit to TB test
4. Submit to a DMV check and provide current copies of driver’s license and car insurance if required to drive

I have read and understood all terms of the policies, benefits, and practices described in the Beach Cities Health District Volunteer Agreement.