Baby Buggy Youth Service Corps
The Youth Service Corps is an opportunity for high school students to participate in
hands-on volunteer projects, build leadership skills, and engage with their community
through service and action.
The Youth Service Corps meets once a week for one hour for 8 consecutive weeks at
the Baby Buggy Warehouse. The first session is mandatory and will include an
orientation, tour of our warehouse, an overview of the project, and a brief video.
At the end of the 8 weeks, participants will receive a Certificate of Completion. Please
note, to receive the certificate, participants must attend 7 out of the 8 sessions.
Schedule:
Tuesday March 1, 2016 – 430pm – 5:30pm – Orientation & Session 1
Tuesday March 8, 2016 – 430pm – 530pm – Session 2
Tuesday March 15, 2016 – 430pm – 530pm – Session 3
Tuesday March 22, 2016 – 430pm – 530pm – Session 4
Tuesday March 29, 2016 – 430pm – 530pm – Session 5
Tuesday April 5, 2016 – 430pm – 530pm – Session 6
Tuesday April 12, 2016 – 430pm – 530pm – Session 7
Tuesday April 19, 2016 – 430pm – 530 – Session 8
*Below you will find the application as well as a photo release form. Please fill out
BOTH the application and the photo release form and send back to us.
Youth Service Corps Application
Contact Information
Name: _____________________________________________________________________
Address: ___________________________________________________________________
Home Phone: _______________________________________________________________
Cell Phone: _________________________________________________________________
E-Mail Address: ______________________________________________________________
Emergency Contact Information
Name: ______________________________________________________________________
Home Phone: ________________________________________________________________
Cell Phone: __________________________________________________________________
Education
School Currently Attending: ______________________________________________________
Last Grade Completed: __________________________
Please list any food allergies:
____________________________________________________________________________
T-Shirt Size
XS S M L XL
How did you hear about this opportunity?
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In four sentences (or more if you need it) tell us about yourself! What should we know
about you?
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
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List any hobbies or special skills:
____________________________________________________________________________
____________________________________________________________________________
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Why are you interested in being part of our Youth Service Corps?
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
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1 fun fact about yourself 
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
MEDIA/MARKETING CONSENT
I, ____________________________________________________________ (Name) living at
________________________________________________________________ (full address)
hereby give permission to _____BABY BUGGY______________________________ (name of
photographer) to photograph me for publication or use in _____ALL MEDIA__________________
(name of marketing piece or publication).
I understand the purpose of this consent and appreciate that my picture, first and last name, and
words will be publicly disclosed. Therefore, I acknowledge that I have the capacity to consent* and hereby
grant permission to the reporter/ photographer to interview and/or photograph myself. The
reporter/photographer may only use my name, likeness, and any biographical information provided by me.
IN WITNESS WHEREOF, I have executed this release on the _________day of ________, 200___.
_______________________________
________________________________
(Signature of Participant)
(Signature of witness)
_______________________________
(Signature of Parent or Guardian if participant is under 18 years old.)
* Capacity to consent means that that individual has the ability, determined without regard to the
individual’s age , to understand and appreciate what it is they are being asked to consent to and to
make an informed decision thereon, 18 NYCRR parts 357.
If you have any questions, or would like more information, please contact our Volunteer
Program Assistant, Jamie Novak, at Jamie@babybuggy.org
Baby Buggy | 306 W. 37th Street 8th Floor | New York, NY 10018