Teen Summer Parent Consent
Dear Parent,
Your son/daughter is interested in volunteering with Loma Linda University Health for the Teen
Summer volunteer program. We welcome enthusiastic teens of all backgrounds and abilities to
serve as volunteers.
We have two (2) 2014 summer sessions for them to choose from:
 Session A: June 16 through July 11
 Session B: July 14 through August 8
Teen volunteers may volunteer a maximum of four (4) hours per day, up to three (3) days per
week, and can select from a morning (8:30 am to 12:30 pm), or afternoon (12:30 pm to 4:30 pm)
shift.
The following steps are required for your teen to become a volunteer:
 Completed online application.
 The application will be reviewed, and upon acceptance, an email will be sent inviting your teen to
sign-up for one of our Teen Interview sessions. The following must be brought to the interview:
o Current report card or letter verifying your son/daughter’s GPA – GPA must be 3.2 or
above
o Signed Teen Summer Parent Consent
 After successful completion of the interview, an email will be sent invit ing your teen to sign-up
for one of our teen orientation sessions. Attendance with a parent or guardian at one of the
Teen Orientation sessions is mandatory.
 A $20.00 processing fee will be collected, upon check-in at orientation.
 Complete sign-up process including ID badge, TB screening and uniform.
We depend on our volunteers. We offer a unique experience and the personal satisfaction of
contributing to the welfare of our patients and guests. Volunteering can also provide an opportunity
for career exploration and service experience that can be listed on college or scholarship applications.
In order to receive the greatest benefit from volunteering, we do have a minimum requirement
of 35 hours during our summer program and the teens must be able to fully commit to one
session. Please choose your session carefully.
Our hosting departments depend on the Teens keeping their commitment to volunteer. Therefore,
attendance is important. Failure to meet your commitment or complete a session may result in
disqualification from the Teen Summer volunteer program. Exceptions will be made for illness,
appointments, and family obligations up to three (3) days of absence during the session. If your
son/daughter cannot make it to your committed shift, please contact the Volunteer Services
office at 909.558.8022 or email to [email protected].
During their volunteer time, they may be transported to various volunteer location throughout our Loma
Linda area. However, once your teen’s shift is over they must be picked up. As a parent, you will
be responsible for the transportation of your teen during the Teen Summer program. This is to
ensure their safety and your piece of mind.
Delighted to be at your
service,
LLUH Volunteer Services
Teen Summer Parent Consent
Please read and complete the Parent Consent for Participation and Authorization for Emergency Medical
Treatment. Please have your teen return this document when they attend the interview. Without this consent
form your teen will not be able to volunteer or be interviewed. Thank you for allowing your teen to volunteer
with LLUH, Volunteer Services this summer.
PARENT CONSENT FOR PARTICIPATION AND AUTHORIZATION FOR
EMERGENCY MEDICAL TREATMENT
Name of Teen volunteer:__________________________________________________________________
Does your teen have any physical or medical condition which may limit his/her
ability to perform the duties of a volunteer?
Yes
No
Yes
No
If yes, please explain:
Has your teen received all age required immunizations including a flu vaccine?
Parental Consent for Participation and Authorization for Emergency Medical Treatment:
I understand that he/she has committed to fulfill the scheduled assignments in order to remain in the
program and that my teen must complete to 35 hours of service during their selected Teen Summer session.
I understand that there is a $20 processing fee for volunteering at LLUH.
I understand that my teen must complete a full session and may only take up to 3 days of absence without
dismissal from the program.
I understand that I must attend the last 15 minutes of the Teen Summer volunteer orientation with my teen.
I understand that I am responsible for dropping off and picking up my teen at the beginning and end of their
shift even when the shift ends early. I will assume responsibility for transportation for his/her participation. I
will assume responsibility to have my teen picked up from their volunteer sight immediately at the end of
their shift.
I hereby give consent for my son/daughter,__________________________________________
to participate in the Teen Summer volunteer program of the LLUH, Volunteer Services department.
I hereby give authorization to Loma Linda University Medical Center to provide necessary emergency medical
care to my son/daughter if illness or injury occurs while he/she is on duty as a volunteer.
I, along with my son/daughter, have read the online/paper/email copy of the Volunteer Agreement in its
entirety. This agreement is provided in the online application found at www.lomalindavolunteers.org, or a
copy can be requested by emailing [email protected].
Parental Signature:
Date:
Print Name:
Phone:
Email Address: