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Contact Information
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First Name
Last Name
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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
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Emergency Contact Info
We will only use this in case you are seriously injured during volunteering opportunities.
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First Name
Last Name
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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.


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

Volunteer Interest
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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. For Volunteer Repair Parties, you may volunteer with us immediately after filling out this application.
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A background check is a requirement of volunteering with Bike Works. Having a criminal background will not necessarily prevent you from volunteering.

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First Name
Last Name

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(mm/dd/yyyy)
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This is required information to run a background check.
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Answering “Yes” will not necessarily prevent you from volunteering at Bike Works.
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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
  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.

 

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First Name
Last Name