Volunteer InformationThank you for your interest in volunteering with us. Volunteers are an integral part of the LoveYourBrain community. Please tell us about yourself!First Name*Last Name*Credentials*PronounsEmail*Confirm email*I agree to receive communications from LoveYourBrain.Phone*StreetCity*State/Province(use 2 letter abbreviation) *Zip/Postal Code*Country*Are you under the age of 18 or under the care of a legal guardian?*YesNo--select an item--Yes No Please tell us more about yourself! The questions in the below section are voluntary.We are working to increase representation throughout our work, so collect the following optional demographic information. LoveYourBrain does not discriminate based on race, ethnicity, age, disability, sexual orientation, gender, or other identities. To learn more about why we ask the below questions, please read our FAQ here.Please select all that apply:I have experienced a brain injuryI am a caregiver/support personI am a clinician or work in brain injury advocacyI am a yoga teacherNone of the aboveI have experienced a brain injury I am a caregiver/support person I am a clinician or work in brain injury advocacy I am a yoga teacher None of the above What is your gender? (this information is used when assigning roommates at Retreats, if applicable)--select an item--Female Male Transgender Female or Trans Woman Transgender Male or Trans Man Genderqueer, neither exclusively male nor female Additional Gender Category or Other We see you as a unique individual and want to ensure you're represented! We recognize this question may not reflect the way you identify. If you'd like, please share more:What is your birthdate?What is your race?Select all that apply. American Indian or Alaska NativeAsianBlack or African AmericanNative Hawaiian or Other Pacific IslanderWhiteSome other race(s)American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Some other race(s) We see you as a unique individual and want to ensure you're represented! We recognize this question may not reflect the way you identify. If you'd like, please share more:Are you of Hispanic, Latino, or Spanish origin? Select all that apply. No, not of Hispanic, Latino, or Spanish originYes, CubanYes, Mexican, Mexican American, or ChicanoYes, Puerto RicanYes, another Hispanic, Latino, or Spanish originNo, not of Hispanic, Latino, or Spanish origin Yes, Cuban Yes, Mexican, Mexican American, or Chicano Yes, Puerto Rican Yes, another Hispanic, Latino, or Spanish origin We see you as a unique individual and want to ensure you're represented! We recognize this question may not reflect the way you identify. If you'd like, please share more:Have you ever served in the US Armed Forces?YesNo--select an item--Yes No Do you consider yourself a member of the LGBTQIA+ (Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, and/or Asexual) community?YesNo--select an item--Yes No Skills & ExperienceIf applicable, please select any skills that you possess or fields that you have experience in.Assisting with mobility support (wheelchair, cane)Certified Yoga TeacherComputer usageCounseling (1:1 and/or group)CPR/First Aid CertifiedCustomer ServiceEvent PlanningFood Prep/ServingFundraisingGrassroots/Community OutreachMarketingMedical ProfessionalMeditationMental Health ProfessionalMindfulnessNutritionSalesforce.comSeizure trainingSocial MediaSuicide Risk Assessment and Management TrainingTrauma-informed careAssisting with mobility support (wheelchair, cane) Certified Yoga Teacher Computer usage Counseling (1:1 and/or group) CPR/First Aid Certified Customer Service Event Planning Food Prep/Serving Fundraising Grassroots/Community Outreach Marketing Medical Professional Meditation Mental Health Professional Mindfulness Nutrition Salesforce.com Seizure training Social Media Suicide Risk Assessment and Management Training Trauma-informed care Volunteer RolesWe offer a variety of volunteer opportunities within our programs and organization more broadly (see here for description). Different roles have different travel and IT responsibilities, shared below: Retreat volunteers travel to one of our Retreat locations for approximately one week. LYB provides food and lodging at the Retreat, but travel (by car or air) is not provided. Retreat locations are currently in the USA only. Events & Fundraising volunteers travel to the event(s) in their region (i.e. LYB Annual Golf Tournament), or support on virtual fundraising campaigns. Events may require single or multi-day support, Program Outreach volunteers work from home on their own computer. Internet and phone access is required. Which volunteer role(s) are you interested in?Events & FundraisingProgram OutreachRetreat: General VolunteerRetreat: Kitchen SupportRetreat: Medical ProfessionalRetreat: Mental Health ProfessionalRetreat: Wellness Team SupportEvents & Fundraising Program Outreach Retreat: General Volunteer Retreat: Kitchen Support Retreat: Medical Professional Retreat: Mental Health Professional Retreat: Wellness Team Support Volunteer Role QualificationsAlmost done! Please tell us a little more.Please explain any skills and experience related to the volunteer role(s) you've selected. *What are you personal motivations for volunteering for LYB?*Please list relevant clinical certification(s)Yoga teacher certification datePlease describe experience you have teaching yoga for TBIAre you willing to travel on behalf of LYB for volunteer activities?*I am willing to driveI am willing to flyI am not willing to travelI am willing to drive I am willing to fly I am not willing to travel Today's dateVolunteer Status--select an item--Applied Accepted Rejected Declined Active Inactive Assumption of the Risk and Waiver of LiabilityAssumption of the Risk and Waiver of LiabilityIn the event that you volunteer for a LoveYourBrain Retreat, you will be in-person with other Retreat personnel and participants. Please acknowledge the below regarding COVID-19: I acknowledge the contagious nature of COVID-19 and agree I will follow all safety guidelines and health protocols communicated by LoveYourBrain and the Retreat host site to the best of my ability. I assume the risk that I may be exposed to or infected by COVID-19 by attending the LYB Retreat and that such exposure or infection may result in personal injury, illness, permanent disability, or death. If I test positive for COVID-19 while at a LYB Retreat, I acknowledge that I would be responsible for leaving the Retreat as soon as possible, which may incur additional costs. I understand and agree that this release includes any Claims based on the actions, omissions or negligence of LYB Retreat, its employees, volunteers, agents, and representatives, whether COVID-19 infection occurs before, during, or after participation in the LYB Retreat.
