Ekam USA Youth Ambassador Form
Please fill the form with the youth ambassador and parent details. At least one parent participation is mandatory.
First Name (Youth Ambassador) *
Your answer
Last Name (Youth Ambassador) *
Your answer
Age *
Your answer
Grade *
Your answer
Email (Youth Ambassador) - if available
Your answer
Phone Number (Youth Ambassador) - if available (111-111-1111)
Your answer
First Name (Parent that will be involved in the program) *
Your answer
Last Name (Parent) *
Your answer
Phone Number of Parent (111-111-1111) *
Your answer
Email (Parent) *
Your answer
City *
Your answer
State *
Select a Chapter *
Citizenship - Youth Ambassador (To determine eligibility for Presidential Volunteer Award) *
Role(s) Youth Ambassador is interested in
NOTE: All volunteers can participate in Ekam Programs and Activities and are eligible for a service hours certificate and for President's Volunteer Service Award (depending on qualification criteria). Youth volunteers who demonstrate commitment to volunteering thru 25 or more service hours and 4 volunteering events in a year are eligible to receive recommendations as Ekam Youth Ambassadors.
WAIVER: In consideration of Ekam USA allowing me/my child/my organization/my family to participate in volunteering opportunities and being aware of the possible injuries or harm that could occur as a result of this participation, I, on behalf of myself, my child, my organization, my family, release Ekam USA, its volunteers, employees, agents, instructors, from any and all injuries and damages whatsoever arising from participation in events
Waiver *
Required
CONTENT: I permit Ekam USA to use photos, audio, video, etc of me/my child/my family participating at volunteering and other events in any marketing materials, on website, social media, etc
Permission *
Required
Submit
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