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Teen Volunteer Program

Union Hospital Teen Volunteer Program for Students 15-18 Years of Age
June 9, 2025 - August 1, 2025

LIMITED POSITIONS AVAILABLE

The Union Hospital Teen Volunteer Program is a rewarding volunteer opportunity for students ages 15-18 to gain experience in medical/non-medical and technology fields in a hospital setting. Enrolled students will volunteer at Union Hospital four (4) hours a week during six (6) out of the Program's eight (8) weeks.

Steps to participate in the 2025 Teen Volunteer Program:

Complete and submit this application by March 21, 2025;
Interview with Union Hospital Volunteer Services (Union Hospital will schedule interviews upon receipt of the confidential school recommendation); and
Complete a two-part orientation: The first part of the orientation will be via Zoom, and the second part will be a simulation training day at the hospital.

DISCLAIMER: "Neither the material and/or activity is sponsored, promoted, or endorsed by the Vigo County School Corporation. With the posting and/or distribution of this material, the sponsoring organization/individual agrees that the Vigo County School Corporation, as well as its individual school board members, administrators, teachers, and other employees, will be held harmless by the sponsoring organization for any liability, cost, damage, and attorney fees that result directly or indirectly from the material contained in the distributed literature and from the programs conducted by the sponsoring organization."

I have previously volunteered at Union Health?

No Yes

Teen First Name

Teen Last Name

Address

ZIP Code

City

State

Teen Date of Birth

Teen Email Address

Teen Phone Number

Name of School

Current Grade

09 (Must be 15 years of age) 10 11 12

Teen Interest, Skills, School Activities

Parent/Guardian Name

Parent/Guardian Email Address

Parent/Guardian Phone Number

Emergency Contact Name

Emergency Contact Relation

Emergency Contact Phone

Family Physician

Family Physician Phone

Teen Agreement : I agree to fulfill the above-described teen volunteer requirement to volunteer 4 hours a week for 6 weeks out of the 8-week program, to fulfill all other described requirements and to follow all guidelines to become a teen volunteer at Union Hospital. (By typing my full name below I agree to the above statement and agree the digital signature is the equivalent to my handwritten signature.) Teen Full Name

Parent/Guardian Agreement : As the parent or legal guardian of the above-named (“Student”), I affirm the information Student provided as part of the application is true and Student has my permission to participate in the Program. I, agree Student will fulfill the four-hour-a-week commitment, which will occur in six of the eight weeks of the Program, and to fulfill all other described requirements and to follow any and all guidelines to become a teen volunteer at Union Hospital. I give permission to Student’s school to provide a confidential recommendation of Student to Union Hospital in connection with this application. I give permission to Union Hospital to administer to Student a blood draw for QuantiFERON TB test and agree to provide documentation of Student’s immunizations, including COVID vaccine or declination, in order to adhere to the rules of infection control. I give parental consent to use or publish name, images of, etc, of the student volunteer for marketing purposes. I authorize any emergency medical treatment that is necessary for Student. In exchange for Student’s opportunity to participate in the Program’s activities, I release and agree not to sue Union Hospital, its affiliates, officers, directors, employees, or other agents (“Union Health”) for any damage, personal injury, or other harm arising as a result thereof, wherever, whenever, or however, the same may occur. Further, I agree to indemnify and hold harmless Union Health for all claims arising out of Student’s participation in the Program.

By typing my full name below, I agree to the above statement and agree the digital signature is the equivalent to my handwritten signature.

Parent/Guardian Full Name

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Teen Volunteer Program

Union Hospital Teen Volunteer Program for Students 15-18 Years of Age June 9, 2025 - August 1, 2025 LIMITED POSITIONS AVAILABLE

Union Hospital Teen Volunteer Program for Students 15-18 Years of Age
June 9, 2025 - August 1, 2025

LIMITED POSITIONS AVAILABLE