Bike Works · Bike Works Volunteer Application

Contact Information

Name

*

First Name

Last Name

Email

*

Verify Email

*

Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Phone

*

Emergency Contact Info

We will only use this in case you are seriously injured during volunteering opportunities.

Emergency Contact Name

*

First Name

Last Name

Emergency Contact Phone

*

Relationship to volunteer

Examples: parent, partner/spouse, caretaker

Demographic Info

We value diversity. Please help us gauge our efforts to create a more inclusive bicycle culture by sharing some information about yourself. This information is required for grant reporting, will be kept confidential, and will not affect your opportunities to volunteer.

Race/Ethnicity

American Indian/Alaska Native

Asian

Black/African American

Latinx

Multi-Racial

Pacific Islander

White/Caucasian

Other (please specify below)

Race/Ethnicity

Gender Identity

Female

Male

Transgender

Non-binary

Other (please specify)

Gender Identity

Are you a military veteran?

Yes

No

Pronouns

Check all that apply so we know how to refer to you!

She/her

He/him

They/Them

Other (please indicate below)

Pronouns

Access Needs

Do you have any access needs that will support your safety and comfort?

Volunteer Interest

Are you performing service learning hours?

*

Yes

No

Does your employer match your financial donations or volunteer hours?

Yes

No

Employer Name

Are you volunteering with a group or organization?

Yes

No

Group/Organization Name

Which volunteer opportunities interest you?

*

Bike Repair

Host a Bike Drive

Board of Directors

Outreach & Tabling

Fundraising Events

Data-Entry/Clerical Support

How would you describe your mechanics experience level?

Beginner

Intermediate

Advanced

Shop-level professional

Do you speak any languages other than English, and if so, would you be interested in translation as a volunteer?

Please include the language(s) you speak in your response

How did you hear about Bike Works?

Bike Shop

Bike Works Event

Other Community Event

Bike Works Flyer or Brochure

Bike Works Website

Bike Works Staff or Board Member

Word of Mouth

Other

If Other, please specify below

Anything else?

If you have other skills you'd like to share, a specific project in mind, or anything else you think we should know about you as a volunteer, let us know here!

Volunteer Background Check

For you to volunteer at Bike Works, we must conduct a background check. Your criminal background will not necessarily prevent you from volunteering at Bike Works.

Do you permit Bike Works to perform a background check?

*

Yes

No

A background check is a requirement of volunteering with Bike Works. Having a criminal background will not necessarily prevent you from volunteering.

Legal Name

*

First Name

Last Name

Alias/Maiden Names

Birthdate

*

(mm/dd/yyyy)

The sex listed on your government ID

*

This is required information to run a background check.

Male

Female

X (non-binary, trans*, or other)

Have you ever been convicted of a crime?

*

Answering “Yes” will not necessarily prevent you from volunteering at Bike Works.

Yes, I have been convicted of a crime

No, I have not been convicted of a crime

Have you ever had findings made against you in any civil adjudicative proceeding?

*

Answering “Yes” will not necessarily prevent you from volunteering at Bike Works.

Yes

No

Have you ever had both a conviction and findings made against you?

*

Answering “Yes” will not necessarily prevent you from volunteering at Bike Works.

Yes

No

If you answered YES to any of the above, please give an explanation below:

I have read the waiver and agree to its terms (please initial below)

*

Electronic Signature

The statements set forth in this application are, to the best of my knowledge, true and complete. I agree that any misstatements or omissions as to material fact will constitute the grounds for unfavorable consideration or dismissal from volunteering with Bike Works. I am aware that a criminal background check will be performed upon submission of this volunteer application.

Bike Works Waiver & Media Release

I understand the nature of Bike Works' sponsored activities at and outside of Bike Works, and warrant that I am qualified, in good health, and in proper physical condition to participate.
I acknowledge that some activities occur on public roads and other facilities on which the risks of travel are to be expected and that some activities occur in a bike shop in which the risks of a shop setting are to be expected. These risks include MINOR & SERIOUS BODILY INJURIES, PERMANENT DISABILITY, PARALYSIS, OR DEATH. These risks may be caused by my actions or inactions, as well as the actions or inactions of pothers participating in the activities.
I release, covenant not to sue, and hold harmless Bike Works, its volunteers, employees and sponsors, as well as other participants ("Releasees") for any and all liability related to activites caused or alleged to be caused or alleged to be caused in whole or in part by the Releasees. I further agree that if, despite this release, I, or anyone on my behalf, make such claim against any of the Releases, I will indemnify and hold harmless the Releasees from any and all costs they incur as the result of such claim including, but not limited to, attorney fees and costs.
In case of an emergency, I hereby authorize and give permission to any physician, hospital, health care provider, or other medical personnel selected by the staff of Bike Works to provide prompt medical treatment and arrange necessary related transportation. I agree that, once I am in the care of medical personnel or a medical facility, Bike Works shall have no further responsibility for me and Iagree to pay all costs associated with such medical care and transportation. I also authorize Bike Works staff to dispense medications to me as needed.
I give permission for Bike Works to use, without limitation or obligation, photographs, film footage or tape recording that may include my image or voice for purposes of promoting Bike Works programs.
I understand that volunteering at Bike Works and taking part in rides is a privilege. It is my responsibility to ride and behave safely at all times. I will practice safe work habits and safe riding habits including wearing a helmet when riding to, from, or on Bike Works programs.

Legal Name

*

First Name

Last Name