Apply to Be a Summer Volunteer

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- Step 1 of 3

Individual Volunteer Application:

As a member of our volunteer team, you'll be at the heart of our mission, driving us toward shared goals and significantly contributing to a brighter future for our youths and communities.

If you're driven to lend your time, skills, and passion to youths, we invite you to fill out this volunteer application.

TELL US ABOUT YOU

Volunteers must be 18 years old or older to apply. *

I am 18 years old or older.

Volunteers must present a negative TB test. TB test results are valid for four years. *

I understand that I must provide a negative TB test.

Full Name *

First

Last

Address *

Address Line 1

City

State

Zip Code

Your Aliases and/or Maiden Name(s):

Preferred Phone *

Date of Birth *

Email *

TELL US ABOUT YOUR INTERESTS

Which Club(s) would you like to volunteer for? Please check all that apply. *

A.C Stelle Club (A.C. Stelle Middle School / Calabasas)
Cal & Marje Johnston Club (Colina Middle School / Thousand Oaks)
Catlin Family Club (Lindero Canyon Middle School / Agoura Hills)
Dr. Richard Grossman Club (Chaparral Elementary School / Calabasas)
John L. Notter Family Club (Redwood Middle School / Thousand Oaks)
Karen & Ed Jefferson Club (Bay Laurel Elementary / Calabasas)
Marion & John E. Anderson Youth Center (Los Cerritos Middle School / Thousand Oaks)
Rocky & Lon Morton Club (Sequoia Middle School / Newbury Park)

Select your preferred volunteer opportunities. Please check all that apply. *

URGENT NEED: Dr. Richard Grossman Boys & Girls Club Helpers (11:30AM - 2:40PM)
Sports Coach: one session per week, two hours per session (minimum of 6 weeks)
Club Front Desk helpers (2:00PM - 4:00PM or 4:00PM - 6:00PM)
Money Matters Program teachers and helpers (hours vary)
STEAM teachers and advisors (hours vary)
Power Hour Program helpers (hours vary)

HELP US PLAN FOR CHANGE BY SHARING YOUR AVAILABILITY

How Many Hours Per Week Are You Available to Volunteer? *

(Please note a minimum requirement of 2-4 Hours)

What is the estimated duration of your commitment? *

(Please note a minimum requirement of 6 weeks. Other options include 3 months, 6 months, indefinitely, etc.)

When are you available to start volunteering? *

Save and Resume Later

Your Unique Talents and Past Contributions

SKILLS AND VOLUNTEER EXPERIENCE

Please list any special skills, areas of expertise, and/or experience you have, including proficiency in non-English languages: *

Please list your previous volunteer experiences, including the name of the organization, or any experience working with youth: *

REFERENCES

Share Three Character References

Include non-family members with verified phone numbers (e.g., teachers, counselors, coaches, employers, community members). Please ensure to pre-notify your references to expect our call.

Name of Your First Reference: *

Relationship to Reference 1: *

Preferred Phone for Reference 1: *

Name of Your Second Reference: *

Relationship to Reference 2: *

Preferred Phone for Reference 2: *

Name of Your Third Reference: *

Relationship to Reference 3: *

Preferred Phone for Reference 3: *

Reference Contact Expectation *

I ACKNOWLEDGE that I am expected to notify my references that they will be contacted upon submission of my application.

EMERGENCY CONTACTS

Your safety is our priority. Please provide emergency contact details:

Name of Your First Emergency Contact: *

Relationship to Emergency Contact 1:

Preferred Phone for Emergency Contact 1:

Name of Your Second Emergency Contact: *

Relationship to Emergency Contact 2:

Preferred Phone Emergency Contact 2:

PREVIOUS EXPERIENCES

Share your previous experiences to showcase your journey.

Have you ever been employed/volunteered with us before? *

Which Club site?

Have you ever been a member of a Boys & Girls Club? *

Which Club site?

What is the name of the Club?

Do you have experience with another non-profit organization, or do you currently serve on a board? *

Please describe your experience:

ADDITIONAL INFORMATION

Each volunteer will receive a special T-shirt featuring the Club logo. Please share your preferred shirt size with us to ensure your T-shirt fits you just right. Whether you're small, 2XL, or any size in between, we want to ensure you feel comfortable and fabulous while making a difference.

What size T-shirt do you wear (adult sizes)? *

Small
Medium
Large
XL
2X

How did you learn about these volunteer opportunities? *

Save and Resume Later

Volunteerism Shapes the Future for Our Youth

The enthusiasm and commitment of our volunteers are the bedrock of our mission, propelling us forward with a shared vision. Volunteering transcends mere participation; it amplifies our efforts, leaving an enduring imprint on the lives of our youth and sparking transformative change. Every task, regardless of its size, contributes to the broader goals to improve the lives of our youths, creating ripples of impact that extend well beyond our immediate community.

Boys & Girls Clubs of Greater Conejo Valley Confidentiality & Authorization Statements

Before proceeding, it's crucial that we explain the importance of confidentiality and the authorization requirements associated with your potential volunteer role. These principles are foundational to maintaining the trust and integrity of our operations and ensuring the privacy and safety of all individuals we serve.

Reference Contact Authorization *

I ACKNOWLEDGE that the Boys & Girls Clubs of Greater Conejo Valley May Contact Any and All of the References I Have Listed.

Background Check Authorization *

I ACCEPT the Background Check Authorization Terms and Conditions Below:

In order to safeguard the well-being of the youth served by our organization, I authorize the BGC/GCV to verify all information provided by me on this application. I hereby authorize any references or background checks listed on this application and/or any educational entity or person on this application to disclose to the organization any and all letters, reports and other information related to my work or educational record, without giving me prior notice of such disclosure. In addition, I hereby release the organization, my former employers, all educational entities listed on this application and all other persons or organizations from any and all claims, demands, or liabilities arising out of or in any way related to such investigation or disclosure.

Social Security Number *

Your SSN is required for a mandatory background check during our volunteer onboarding process.

Criminal History Records Authorization *

I ACCEPT the Criminal History Records Authorization Terms and Conditions Below:

I understand it is a requirement of the organization that all volunteers who work with or have contact with children be fingerprinted. I understand that the fingerprints will be used to check the criminal history records of the State of California, in addition to nationwide records. I authorize the BGC/GCV, and any agency they may contact, to conduct a complete criminal background investigation.

The BGC/GCV requires all current staff, volunteers and applicants 18 years old and over being considered for employment to undergo a criminal background investigation. Volunteers will ONLY begin working when application, reference checks, criminal history, and fingerprints have been processed and cleared.

Member Privacy, Trust, and Confidentiality *

I ACCEPT the Member Privacy, Trust, and Confidentiality Terms and Conditions Below:

While volunteering with the BGC/GCV, information about the lives, abilities, and concerns of youth may be shared with you. This information is of a confidential nature. You must understand and respect the rights of privacy of our members and their families. You are required to use sound judgment in handling confidential information including reproducing copies of documents or disseminating information inside or outside the organization. Similar to a BGC/GCV employee, you as a volunteer are bound by a code of ethics to keep confidential matters within the confines of this organization. You may not discuss such information with anyone who does not have a professional right to know.

Suspected Child Abuse Reporting *

I ACCEPT the Suspected Child Abuse Reporting Terms and Conditions Below:

The California Penal Code requires individuals who are actively involved with youth to report suspicion and/or knowledge of child abuse. All clubhouse staff/volunteers must immediately inform their clubhouse director of any suspected child abuse. Clubhouse Directors are responsible for assisting the staff/volunteers in completing the Suspected Child Abuse Report. Suspected child abuse must be reported immediately (or as soon as practically possible) by telephone with a written report sent within 36 hours of receiving the information regarding the incident. (LA County – 800-540-4000; Ventura County – 805-654-3200)

One on One Contact Policy at the Club(s) *

I ACCEPT the One on One Contact Policy Terms and Conditions and Will Be in Compliance During Club Hours.

Non-Fraternization Policy and Acknowledging Professional Boundaries *

I ACCEPT the I Accept the Non-fraternization Policy and Will Be in Compliance to the Organization Rules.

Release and Waiver of Liability and Indemnity Agreement *

I ACCEPT the Release and Waiver of Liability and Indemnity Agreement for Myself and Have Read this Release:

IN CONSIDERATION of being permitted to utilize the facilities, services and programs of the Boys & Girls Clubs of Greater Conejo Valley for any purpose, including, but not limited to observation or use of facilities or equipment, or participation in any offsite program affiliated with the Boys & Girls Clubs of Greater Conejo Valley, the undersigned, for himself or herself and any personal representatives, heirs, and next of kin and children hereby acknowledges, agrees and represents that he or she has, or immediately upon entering or participating will, inspect and carefully consider such premises and facilities or the affiliated program. It is further warranted that such entry into the Boys & Girls Clubs of Greater Conejo Valley for observation or use of any facilities or equipment of participation in such affiliated program constitutes an acknowledgement that such premises and all facilities and equipment thereon and such affiliated program have been inspected and carefully considered and that the undersigned finds and accepts same as being safe and reasonably suited for the purpose of such observation, use of participation.

IN FURTHER CONSIDERATION OF BEING PERMITTED TO ENTER THE BOYS & GIRLS CLUBS OF GREATER CONEJO VALLEY FOR ANY PURPOSE INCLUDING, BUT NOT LIMITED TO OBSERVATION OR USE OF FACILITIES OR EQUIPMENT, OR PARTICIPATION IN ANY OFF-SITE PROGRAM AFFILIATED WITH THE BOYS & GIRLS CLUBS OF GREATER CONEJO VALLEY, THE UNDERSIGNED HEREBY AGREES TO THE FOLLOWING:

1. THE UNDERSIGNED HEREBY RELEASES, WAIVES, DISCHARGES AND CONVENANTS NOT TO SUE the Boys & Girls Clubs of Greater Conejo Valley, its directors, officers, employees, and agents (hereinafter referred to as “releases”) from all liability to the undersigned, his personal representatives, assigns, heirs, and next of kin and children for any loss or damage, and any claim or demands therefore on account of injury to the person or property or resulting in death of the undersigned, whether caused by the negligence of the releases or otherwise while the undersigned is in, upon, or about the premises or any facilities or equipment therein or participating in any program affiliated with the Boys & Girls Clubs of Greater Conejo Valley.

2. THE UNDERSIGNED HEREBY AGREES TO INDEMNIFY AND SAVE AND HOLD HARMLESS the releases and each of them from any loss, liability, damage or cost they may incur due to the presence of the undersigned in, upon or about the Boys & Girls Clubs of Greater Conejo Valley premises or in any way observing or using any facilities or equipment of the Boys & Girls Clubs of Greater Conejo Valley or participating in any program affiliated with the Boys & Girls Clubs of Greater Conejo Valley whether caused by the negligence of the releases or otherwise.

3. THE UNDERSIGNED HEREBY ASSUMES FULL RESPONSIBILITY FOR AND RISK OF BODILY INJURY, DEATH OR PROPERTY DAMAGE due to negligence of release or otherwise while in, about or upon the premises of the Boys & Girls Clubs of Greater Conejo Valley and/or while using the premises or any facilities or equipment thereon or participating in any program affiliated with the Boys & Girls Clubs of Greater Conejo Valley.

A. THE UNDERSIGNED further expressly agrees that the foregoing RELEASE, WAIVER AND INDEMNITY AGREEMENT is intended to be as broad and inclusive as is permitted by the law of the State of California and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

B. THE UNDERSIGNED HAS READ AND VOLUNTARILY SIGNS THE RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT, and further agrees that no oral representations, statements for inducement apart from the foregoing written agreement have been made.

Rules of Conduct for At-Will Volunteerism *

I AGREE to the Rules of Conduct for At-Will Volunteerism Terms and Conditions Below:

Volunteerism At-Will
Every Club volunteer has an at-will relationship with the Club. Volunteers are free to resign their position
at any time, just as the Club is free to terminate a volunteer for any reason at any time.

Volunteer Count
Volunteers are a vital part of our organization. We keep an accurate count of the number of volunteers and the amount of hours they serve at the Club on a daily, weekly, and monthly basis. We ask that all volunteers sign in and out for every volunteer shift. We also ask that all volunteers wear a name badge to be easily recognized by staff, members, and parents.

Manner and Professionalism
Volunteers are expected to behave in an appropriate and professional manner at all times. Volunteers are
viewed as role models to the members and should always keep this top of mind when interacting or
assisting in the program areas.

Code of Ethics for Employees and Volunteers Disclosure Statement *

I AGREE to the Code of Ethics for Employees and Volunteer Disclosure Statment Terms and Conditions Below:

The purpose of “A Matter of Trust: Our Code of Ethics” is to help ensure that all employees of Boys & Girls Clubs of Greater Conejo Valley adhere to proper ethical standards, abide by the law, and preserve the mission, purpose, integrity, reputation, and professional and business relationships of Boys & Girls Clubs of Greater Conejo Valley. Boys & Girls Clubs of Greater Conejo Valley expects all employees to conduct themselves in a manner that exemplifies the highest standards of ethics and propriety in any endeavor or activity that could impact or reflect upon the mission, purpose, integrity, reputation, and professional and business relationships of Boys & Girls Clubs of Greater Conejo Valley.

Recognizing that it is not possible to address all ways in which ethical issues may arise, the following principles are intended as a guide in making sound judgments and decisions on behalf of Boys & Girls Clubs of Greater Conejo Valley and its mission, not as a comprehensive list of potential concerns.

Pledge of Personal and Professional Conduct:

• Integrity -- I will demonstrate the highest standards of individual conduct, personal accountability, integrity, trustworthiness, fair dealings, considerations of the rights of others, and the highest principles of good business relationships.

• Excellence -- I will strive to meet the highest standards of performance, quality, service and achievement.

• Honesty -- I will communicate directly, respectfully, honestly and openly, and avoid misrepresentation.

• Diversity -- I will support and value diversity -- promoting a working environment that embraces the similarities and differences all people bring to the organization.

• Respect -- I will respect and act fairly toward all those with whom I come into contact and refuse to engage in or tolerate any form of discrimination or harassment.

• Responsibility -- I will take responsibility for my actions and decisions and remain a careful steward of the funds and resources entrusted to me.

• Compliance -- I will comply with Boys & Girls Clubs of Greater Conejo Valley Code of Ethics, Employee Handbook, policies, procedures and all laws and regulations affecting BGCA.

While the “Pledge” outlines general principles guiding our ethical conduct, the following points illustrate important applications that are relevant to our everyday work. The points below are not intended to be all-inclusive. Employees are expected to utilize good judgement in
maintaining the highest standards of ethics.

Professional Practices
• I will not place my personal interest in conflict with the mission, purpose, vision, or interests of Boys & Girls Clubs of Greater Conejo Valley, and will avoid any conduct that may impair my judgment with respect to Boys & Girls Clubs of Greater Conejo Valley.

• I will enter into business transactions on behalf of Boys & Girls Clubs of Greater Conejo Valley and otherwise that are in the best interests of BGC/GCV and its mission, and that do not, in any way, conflict with, compromise, or detract from Boys & Girls Clubs of Greater Conejo Valley mission, purpose, or interests.

• I will not, directly or indirectly, benefit improperly from my position or from any sale, purchase, or other activity of the organization.

• I will avoid situations involving conflict or the appearance of conflict between duty to the organization and personal interest.

• I will not accept from or give to any current or potential supplier, customer, competitor, or donor any payment, service, gratuity, gift, or favor of more than nominal value unless explicitly approved by the President.

• I will not ask for or receive cash, kickbacks, bribes, gifts or favors.

• I will avoid any outside business relationships with donors, other businesses or competitors if that relationship creates a conflict of interest by influencing decisions made by me in the performance of my regular duties Boys & Girls Clubs of Greater Conejo Valley.

• I will ensure that travel, entertainment and related expenses are incurred on a basis consistent with the mission of BGCA and not for personal gain or interests.

• I will reveal any perceived, potential or actual conflicts of interest.

Conflicts of Interest:
• I will do my part to ensure that Boys & Girls Clubs of Greater Conejo Valley complies with prescribed accounting polices and procedures at all times.

• I will do my part to ensure that organizational assets and transactions are handled with the strictest integrity, and that each transaction is executed in accordance with applicable procedures, authorization and documentation.

• I will not make false or misleading entries in any books, records or reports, invoices, timesheets, expense reports or aid others in doing so.

• I will not use, directly or indirectly, the organizational name or logo, organizational funds, property, computer connectivity, equipment, assets, copyrighted material or other organizational resources for any unlawful, unethical, or inappropriate purpose.

Assets, Financial Reporting and Transactions:
• I will enthusiastically promote genuine voluntary giving and prevent or inhibit any solicitations made under duress or coercion.

Fundraising:
• I will be accurate and truthful in our fundraising activities.

• I will respect the informed choices of our donors by fairly and truthfully reporting our fundraising costs and overhead.

• I will be clear about how donated resources will be utilized.

• I will honor our promises by using donated resources in the manner in which they were intended or transparently informing donors of any important alterations in the planned use of the funds.

• I will not release business information that has not been made public to private individuals, organizations, or government bodies unless demanded by legal process.

• I will not use confidential information obtained in the course of my employment or affiliation with Boys & Girls Clubs of Greater Conejo Valley for the purpose of advancing any private interest or otherwise for personal gain.

• I will refer all requests for information about present or former employees of the organization to the Human Resources department for handling.

• I will refer requests for confidential or sensitive information from the media to the Chief Executive Officer.

Confidential Information:
• I will not make - or create the appearance of making - any contributions to any candidate for public office or political committee on behalf of Boys & Girls Clubs of Greater Conejo Valley.

• I will not use – or create the appearance of using - any organizational financial resources, facilities or personnel to endorse or oppose a candidate for public office.

• I will clearly communicate that I am not acting on behalf of the organization, if identified as an official of Boys & Girls Clubs of Greater Conejo Valley, while engaging in political activities in an individual capacity.

• I will engage in personal political activities on my own time and at my own expense.

Political Activities Reporting and Investigation:
Upon receipt of the Code of Ethics, each employee will agree in writing to comply with the Code
of Ethics Such agreements, as well as compliance with the Code of Ethics, are conditions of employment for each employee

Conditions of Employment:
Annette Horenstein, Human Resources Director is the Boys & Girls Clubs of Greater Conejo Valley Ethics Officer. If you are not comfortable reporting an incident to your direct superior for any reason, Human Resources Director will take the information in confidence.

Ethics Officers:
Any questions regarding the Code of Ethics, its’ interpretation or application should be directed to the Ethics Officer.

• If an employee knows of a violation of the Code of Ethics, he/she should immediately report it to his or her supervisor, department head or the Ethics Officer.

• If an employee is concerned that he/she may not be in compliance with the Code of Ethics, he/she should complete the appropriate Disclosure Statement, and the Ethics Officers will provide a written response.

• Any supervisor or department head receiving such a report must immediately advise the
• organization’s Ethics Officer.

• There will be no retaliation or intimidation for reporting of actual or possible violations of the Code of Ethics. Such reporting may be anonymous. If not anonymous, the identity of the reporting employee will be kept confidential unless it must be revealed in order to fully enforce this Code of Ethics or comply with legal obligations.

• Boys & Girls Clubs of Greater Conejo Valley Ethics Officer will promptly investigate all alleged Code of Ethics violations of BGCA employees and will take whatever corrective action is required. Employees are expected to cooperate in the investigation.

Questions and Reporting:
• Authorizing or directly participating in actions that violate the Code of Ethics.

• Concealing a violation of the Code of Ethics.

• Failing to detect or report an employees’ violation of the Code of Ethics, if such failure reflects inadequate supervision or lack of oversight.

• Refusing to cooperate in the investigation of a violation of the Code of Ethics;

• Retaliating, directly or in directly, against an individual for reporting a violation of the Code of Ethics

Disciplinary Action for Violations:
• Disciplinary action may be taken for the following violations, and may include dismissal, when appropriate.

I am in compliance with the code of ethics policy. I understand that I am responsible for adhering to the principles of the code of ethics, and I confirm that I will conduct myself in accordance with the principles of the code of ethics.

I acknowledge that I have received and read my personal copy of the Boys & Girls Clubs of Greater Conejo Valley code of ethics.

Child Abuse Reporting Guidelines Disclosure *

I ACCEPT the Child Abuse Reporting Guidelines Disclosure Terms and Conditions Below:

The Boys & Girls Clubs of Greater Conejo Valley Child Abuse Reporting Guidelines are based upon the California Penal Code and are consistent with the values of the agency. I understand that if I have any questions regarding these guidelines I am responsible for addressing them to my Clubhouse director or other appropriate manager. I agree to comply with the stated guidelines and understand that failure to do so may result in disciplinary action up to and including termination.

OVERVIEW:
The California Penal Code requires individuals who are actively involved with youth to report suspicion and/or knowledge of child abuse. Not only is this a California legal requirement, it is also consistent with Boys & Girls of Greater Conejo Valley mission of providing our club members with a “safe place.”

REPORTING PROCESS:
All clubhouse staff/volunteers must immediately inform their clubhouse director of any suspected child abuse. Clubhouse Directors are responsible for assisting the staff/volunteers in completing the Suspected Child Abuse Report. If unable to report to the clubhouse director, the Staff/Volunteers must report to the President/CEO; however, if neither is available, the Staff/Volunteers must commence the reporting process immediately. Suspected child abuse must be reported immediately (or as soon as practically possible) by telephone with a written report sent within 36 hours of receiving the information regarding the incident. The initial phone report is made as follows:

• To report child abuse in Los Angeles County, contact the Child Protection Hotline 24 hours a day, days a week Toll-free within California, phone (800) 540-4000.
If calling from outside of California, phone (213) 639-4500 TDD [Hearing Impaired] (800) 272-6699.

• To report child abuse in Ventura County, Contact the Department of Children and Family Services To report child abuse call (805) 654-3200 any time, day or night. Collect Calls Accepted 8AM - 5PM Monday-Friday.

The written report must be submitted on Department of Justice form 8572 (“Suspected Child Abuse Report”). Staff/Volunteers should provide their Clubhouse Director with a copy to be retained at Boys & Girls of Greater Conejo Valley. If there is uncertainty as to whether or not the child was abused, the employee may seek “consultation” from the case worker prior to deciding to report the suspected abuse. Regardless, employees should always obtain the name of the case worker involved in case of the need for follow-up. The name should be noted on the form 8572 in section B under “Official contacted.”

TYPES OF ABUSE SUBJECT TO REPORTING:
The following types of abuse must be reported by mandated reporters:

A physical injury inflicted by other than accidental means upon a child. Note that child abuse does not include a "mutual affray between minors. It also does not include an injury caused by "reasonable and necessary force used by a peace officer acting within the course and scope of his or her employment."

1. Sexual abuse of a child, including both sexual assault and sexual exploitation. "Sexual assault" includes sex acts with a child, lewd or lascivious acts with a child, and intentional masturbation in the presence of a child. "Sexual exploitation" includes preparing, selling, or distributing pornographic materials involving children; employing a minor to perform in pornography; and employing or coercing a child to engage in prostitution.

2. Willful cruelty or unjustifiable punishment, including inflicting or permitting unjustifiable physical pain or mental suffering, or endangering the child's person or health. "Mental suffering" in and of itself is not required to be reported. However, it may be reported.

3. Willful infliction of cruel or inhuman corporal punishment or injury resulting in a traumatic condition.

4. Neglect of a child, whether "severe" or "general," by a person responsible for the child's welfare. The term "neglect" includes both acts or omissions harming or threatening to harm the child's health or welfare.

IMMUNITY FOR REPORTING CHILD ABUSE:
Mandated reporters have immunity from criminal or civil liability for any report required under the Child Abuse Reporting Law. Supervisors are prohibited from preventing, retaliating against or in any manner punishing an employee for reporting suspected child abuse. However, employees must report suspected child abuse to their management unless to do so would prevent a timely reporting; in such cases the employee must submit a copy of the written report to their manger after the reporting.

The mandated reporter's identity is confidential and may only be disclosed to specified persons and agencies. Mandated reporters and others acting at their direction are not liable civilly or criminally for photographing the victim and including the photograph with their report.

LIABILITY FOR FAILURE TO REPORT:
A mandated reporter who fails to report suspected child abuse is guilty of a misdemeanor punishable by up to six months in jail and/or by a $1,000 fine. He or she may also be found civilly liable for damages, especially if the child-victim or another child is further victimized because of the failure to report. Failure to notify their manager of suspected child abuse is subject to disciplinary action.

DEFINITIONS:
Child: “Child” is any individual less than 18 years of age. This applies to club members, employees, visitors etc.

Child abuse:
a. A physical injury which is inflicted by other than accidental means on a child by another person.
b. Sexual abuse, including both sexual assault and sexual exploitation.
c. Willful cruelty or unjustifiable punishment of a child.
d. Cruel or inhuman corporal punishment or injury.
e. Neglect, including both severe and general neglect.
f. Abuse (all of the above) in out-of-home care.

Indicators of child abuse:
1. Physical Abuse: Physical abuse may be defined as any act which results in a non-accidental physical injury. Indicators of physical abuse:
• Bruises, burns, abrasions, lacerations, or swelling caused by other than accidental means.
• Belt buckle marks, handprints, bite marks and pinches.
• Child states injury was caused by abuse.
• Injury unusual for a specific age group.
• A history of previous or recurrent injuries.
• Unexplained injuries; conflicting explanations or reasons for injury.
• Child excessively passive, compliant or fearful.
• Caretaker attempts to hide injuries.

2. Neglect: Neglect is essentially the negligent treatment or maltreatment of a child by a parent or caretaker under circumstances indicating harm or threatened harm to the child's health or welfare. Indicators of neglect:
• Child lacking adequate medical or dental care.
• Child is always sleepy or hungry.
• Child is always dirty or inadequately dressed for weather conditions.
• There is evidence of poor supervision.
• Conditions in home are extremely or persistently unsafe or unsanitary.

3.Sexual Abuse: Sexual abuse is defined as acts of sexual assault on and the sexual exploitation of minors. Indicators of sexual abuse:
• Child reports sexual activities to a trusted person.
• Detailed and age-inappropriate understanding of sexual behavior (especially by younger children).
• Child wears torn, stained or bloody underclothing.
• Child is victim of other forms of abuse.

Consent For Criminal Background Check Authorization *

I GIVE PERMISSION to the Boys & Girls Clubs of Greater Conejo Valley to obtain information relating to my criminal history record through Trusted Employees.
I UNDERSTAND that this information will be used in part to determine my eligibility for an Employment, with this organization.
I UNDERSTAND that as long as I remain in such capacity here, the criminal history records check will be repeated annually.
I UNDERSTAND that I will have an opportunity to review the record as received by Boys & Girls Clubs of Greater Conejo Valley and a procedure is available for clarification, if I dispute the record as received.
I UNDERSTAND that the criminal history could contain information presumed to be expunged.
I UNDERSTAND, the undersigned, do, for myself, my heirs, executors and administrators, hereby remise, release, and forever discharge and agree to indemnify Trusted Employees and Boys & Girls Clubs of Greater Conejo Valley each of their officers, directors, employees, and agents and hold them harmless from and against any and all causes of actions; suits; liabilities; costs; debts; and sums of money, claims, and demands whatsoever (including claims for negligence, gross negligence, and/or strict liability) and any and all related attorney’s fees, court costs, and other expenses resulting from the investigation of my background in connection with my application to serve.

The criminal history record, as received from the reporting agencies, may include criminal check, lawsuits, judgments, liens, bankruptcies. BGC/GCV is committed to selecting and retaining the best staff and volunteers to serve its youth. As part of the initial selection process and on an on-going basis, BGC/GCV will conduct background checks in accordance with the following policy: BGC/GCV will conduct criminal background checks of all employees and volunteers, including minors, who have direct, repetitive contact with children. Name-based or fingerprint-based record searches may be used in any combination but shall, at a minimum, (a) verify the person’s identity and legal aliases, ( b) provide a national Sex Offender Registry search, and (c) provide a national criminal record search. (d) provide a comprehensive local criminal search which includes either a statewide criminal search or county level criminal search, Such checks shall be conducted prior to employment and at regular intervals not to exceed twelve (12) months.

All background check findings shall be considered when making employment or volunteer decisions. It is the policy of BGC/GCV that an employee or volunteer will be automatically ineligible for employment or volunteer service, if such individual: (a) refuses to consent to a criminal background check, (b) makes a false statement in connection with such criminal background check, (c) is registered, or is required to be registered on a State or National sex offender registry, (d) has been convicted of a felony consisting of:
1. murder
2. child abuse
3. has been convicted of any misdemeanor or felony against children, including child pornography
4. domestic violence
5. a crime involving rape or sexual assault
6. arson
7. physical assault, battery
(e) has been convicted of a drug-related offense committed within the last five years.
8. weapons
9. has been convicted of any misdemeanor or felony against children

A Summary of Your Rights Under the Fair Credit Reporting Act *

I ACKNOWLEDGE the Summary of Rights Under the Fair Credit Reporting Act Notice Below:

The federal Fair Credit Reporting Act (FCRA) promotes the accuracy, fairness, and privacy of information in the files of consumer reporting agencies. There are many types of consumer reporting agencies, including credit bureaus and specialty agencies (such as agencies that sell information about check writing histories, medical records, and rental history records). Here is a summary of your major rights under the FCRA. For more information, including information about additional rights, go to www.consumerfinance.gov/learnmore or write to:
Consumer Financial Protection Bureau
1700 G Street N.W.
Washington, DC 20552

• You must be told if information in your file has been used against you. Anyone who uses a credit report or another type of consumer report to deny your application for credit, insurance, or employment – or to take another adverse action against you – must tell you, and must give you the name, address, and phone number of the agency that provided the information.

• You have the right to know what is in your file. You may request and obtain all the information about you in the files of a consumer reporting agency (your “file disclosure”). You will be required to provide proper identification, which may include your Social Security number. In many cases, the disclosure will be free.

You are entitled to a free file disclosure if:
• a person has taken adverse action against you because of information in your credit report;
• you are the victim of identity theft and place a fraud alert in your file;
• your file contains inaccurate information as a result of fraud;
• you are on public assistance;
• you are unemployed but expect to apply for employment within 60 days.

In addition, all consumers are entitled to one free disclosure every 12 months upon request from each nationwide credit bureau and from nationwide specialty consumer reporting agencies. See www.consumerfinance.gov/learnmore for additional information.

• You have the right to ask for a credit score. Credit scores are numerical summaries of your credit-worthiness based on information from credit bureaus. You may request a credit score from consumer reporting agencies that create scores or distribute scores used in residential real property loans, but you will have to pay for it. In some mortgage transactions, you will receive credit score information for free from the mortgage lender.

• You have the right to dispute incomplete or inaccurate information. If you identify information in your file that is incomplete or inaccurate, and report it to the consumer reporting agency, the agency must investigate unless your dispute is frivolous. See www.consumerfinance.gov/learnmore for an explanation of dispute procedures.

• Consumer reporting agencies must correct or delete inaccurate, incomplete, or unverifiable information. Inaccurate, incomplete or unverifiable information must be removed or corrected, usually within 30 days. However, a consumer reporting agency may continue to report information it has verified as accurate.

• Consumer reporting agencies may not report outdated negative information. In most cases, a consumer reporting agency may not report negative information that is more than seven years old, or bankruptcies that are more than 10 years old.

• Access to your file is limited. A consumer reporting agency may provide information about you only to people with a valid need – usually to consider an application with a creditor, insurer, employer, landlord, or other business. The FCRA specifies those with a valid need for access.

• You must give your consent for reports to be provided to employers. A consumer reporting agency may not give out information about you to your employer, or a potential employer, without your written consent given to the employer. Written consent generally is not required in the trucking industry. For more information, go to www.consumerfinance.gov/learnmore.

• You may limit “prescreened” offers of credit and insurance you get based on information in your credit report. Unsolicited “prescreened” offers for credit and insurance must include a toll-free phone number you can call if you choose to remove your name and address from the lists these offers are based on. You may opt-out with the nationwide credit bureaus at 1-888-567-8688.

• You may seek damages from violators. If a consumer reporting agency, or, in some cases, a user of consumer reports or a furnisher of information to a consumer reporting agency violates the FCRA, you may be able to sue in state or federal court.

• Identity theft victims and active duty military personnel have additional rights. For more information, visit www.consumerfinance.gov/learnmore. States may enforce the FCRA, and many states have their own consumer reporting laws. In some cases, you may have more rights under state law. For more information, contact your state or local consumer protection agency or your state Attorney General.

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