2024 Hanai Volunteer Application

* required fields

Full Name*:
Date*:

Age (minimum age 21)*:
Address*:

Phone Number*:
Email*:

Emergency Contact (Name & Phone Number)*:

Driver’s License #*:
Vehicle Insurance Company*:

1. Please tell us about yourself (job, age, hobbies, etc.)*:

2. Why are you interested in US4K’s Hanai Mentorship Program?*:

3. Summarize your volunteer and related work experience. Do you have any experience working with
foster youth?*:

4. What are your goals or hopes for volunteering with Hanai?*:

5. Have you ever been charged or convicted with a felony?*:YesNo

a. If yes, please explain:

6. Have you volunteered at any of our surf camps before?*:

7. How did you hear about our Hanai mentorship program?*:

8. What sort of recreational activities do you regularly participate in?*:

9. What area will you be volunteering in?*:San DiegoOrange County/LA

10. What message do you hope to instill in foster youth by the end of the season?*:

11. What age group and gender would you prefer to be grouped with (e.g. elementary school, middle school, high school, boys only, girls only, both boys and girls, etc)?*:

Hanai is a mentorship program where the same group of volunteers and foster youth come together once a month to enjoy a physical or outdoor activity. All outings take place on Saturdays or Sundays. Consistency and dependability are of the utmost importance in this volunteer role.
"You don't realize what a difference you make, but you really do." -Libby (grandma)
"Our kids' guardians and caretakers tell us how impactful spending time with these kids is and making the time once a month makes a profound difference in the rest of the week or month for that participant, that's why I keep coming back." -Matthew (volunteer)
Do you understand the purpose of the Hanai program and that it requires a once per month commitment for 7 months?*:YesNo

I acknowledge the required commitment for this program and am able to adhere to this.
Please initial:

**Please note that Urban Surf 4 Kids staff and leaders are the only ones authorized to take photos of youth. Mentors are only allowed to post photos onto social media if given approval from staff, leaders, and caregivers.

Urban Surf 4 Kids volunteers are prohibited from posting or distributing pictures of youth at events. I acknowledge that as a volunteer I cannot take or post pictures of the youth I work with on social media. Urban Surf 4 Kids takes pictures of our volunteers and youth via our staff members and our commercial event photography vendors. I acknowledge that these pictures will sometimes be utilized in social media campaigns and advertisements.
Please initial:

I acknowledge that surfing & other physical activities with Hanai may be dangerous and I accept and assume such risks, both known and unknown and assume full responsibility for my participation. I am aware that open water activities in general, and surfing specifically, involves inherent risks. I hereby release, indemnify and hold harmless Urban Surf 4 Kids of all Hanai activities from any and all liability in connection with any injury I may sustain (including any injury caused by negligence) in conjunction with volunteering with US4K.
Please initial:

Along with this application, you must submit the following:
o Copy of your auto insurance*
o DMV driving record*
o LiveScan background check ($22-$30)
Attach PDF or JPG file(s) here:

**To complete a LiveScan background check:
Download the BCIA Fingerprints document form, pre-filled with our info, for the background check. Take the form to any live scan facility and get your fingerprints rolled.
A list of live scan facilities in San Diego can be found at:
https://oag.ca.gov/fingerprints/locations?county=San%20Diego. The live scan roll fee is around $22-$30, which you would be responsible for when you visit the place of business that provides the service. We will gladly reimburse you for the fee if that’s the only thing keeping you from this program.
Billing for the actual background check will be sent to US4K by the DOJ and will be paid for by US4K.

You will also be required to attend a mandatory training session.

AUTHORIZATION (required): I certify that the answers given in this application are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this
application as may be necessary for the purposes of determining an appropriate and satisfactory
volunteer position for me. I understand that false or misleading information provided in my
application may result in my not being able to continue as a volunteer with Hanai.
Please initial:

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