Concrete Safaris Youth Leadership Council Application

Email Address *

What will you gain by being a part of the Concrete Safaris Youth Leadership Council? You will:

Receive monthly outdoor adventures

Leadership, Professional, Interpersonal Development Trainings

Learn how to influence a neighborhood and city

Gain insight into college and career opportunities

Gain more confidence in communicating ideas

Meet other youth leaders across NYC

Incentives (Free stuff)

We are looking for youth who:

Concrete Safaris Alumni

Are excited about working with and advocating for social/environmental justice

Have a desire to learn

Are responsible, dependable, and willing to commit

Are willing to be challenged

Are excited to share leadership, power, and recognition

Seek ways to grow, develop and work toward self-improvement

Value different points of views

How to apply to be a member of the Concrete Safaris Youth Leadership Council?

Read the following requirements thoroughly before submitting your application.

Your commitment to Concrete Safaris Youth Leadership Council involves the following requirements:

Embrace the outdoors with a commitment to play outside as much as possible

If available, participate in additional meetings or networking events as scheduled.

Bring your voice, perspective, and great personality to every meeting.

Be open to taking risks and learning from people with different opinions.

Meet twice a month, one virtual meeting, and one in-person meeting at an adventure location.

Complete Independent leadership challenges assigned by the CS YLC facilitator.

As well as a group end-of-the-year social action project.

Willing to take on the role as Concrete safaris Youth Ambassador

First and Last Name *

Applicant Phone Number *

Name of School *

Grade *

Age *

I have access to the internet *

Yes
No
Sometimes

I check my email... *

Daily
Weekly
Monthly

My career interest(s) are in these areas: (It's ok if you are not sure) *this is so we can connect you to professionals in these fields.

Business
Education
Medicine
Marketing
Government
Technology
Science
Music
Visual Arts
Fashion
Psychology
Other

Short Answer Section

Please respond to the following questions with 3-5 sentence minimum.

What is it about the Youth Leadership Council that prompted you to apply? *

How do you hope to grow from your participation in the Youth Leadership Council? *

What strengths do you have that will contribute to the Youth Leadership Council? *

Describe some issues that youth your age are currently facing? *

If you were a superhero who had a superpower that could create change, what power would you have and how would you use it to improve your community? *

Share a personal story of when you felt proud of yourself. *

LIABILITY WAIVER & RELEASE AGREEMENT

This Liability Waiver and Release Agreement {the “Agreement”) sets forth the parties’ understanding and agreement with respect to your participation in the NYC Open Streets - Street Team hosted by Concrete Safaris (“CS”), which is currently scheduled through 2020 (the “Program”). Your participation in the Program is contingent on your execution of this Agreement.

WAIVER AND RELEASE

In consideration of your ability to participate in the Program, you, on behalf of yourself and your heirs, executors, administrators, representatives and assigns, hereby release, waive, discharge, covenant not to sue and hold harmless, CS, its directors, officers, employees, agents, successors and assigns (hereinafter referred to as the "Releasees") from any and all claims, damages, actions, costs, expenses or losses, whether known or unknown, which now exist or which may exist in the future including without limitation, attorneys’ fees, property damage, personal injury, illness or death, whether caused by negligence, omission or otherwise, in connection with or arising out of your participation in the Program, and you further agree to indemnify and hold harmless the Releasees from and against any and all claims, damages, liabilities arising out of your participation in the Program.

You acknowledge and agree that your participation in the Program involves certain risks to you and that you are voluntarily participating in the Program with knowledge and understanding of the dangers involved. In particular, you acknowledge that the novel coronavirus, COVID-19, has been declared a worldwide pandemic, is extremely contagious, and that federal, state and local health agencies and governments recommend social distancing and other protective measures to help prevent the spread of the virus. You acknowledge that, even with the use of protective equipment and other safety precautions, you may be exposed to or contract COVID-19 during the course of your participation in the Program, and you, on behalf of yourself and your heirs, executors, administrators, representatives and assigns, hereby release, waive, discharge, covenant not to sue and hold harmless the Releasees from any and all claims, damages, actions, costs, expenses or losses arising out of or in connection with any potential exposure to COVID-19 (the release in this paragraph and the foregoing paragraph collectively, the “Release”).

Accordingly, you hereby assume full responsibility for the risk of any bodily injury, illness or death or property damage to your personal property while you are participating in the Program.

You further expressly agree that the foregoing Release is intended to be as broad and inclusive as is permitted by the law of the State of New York. If any portion thereof is held invalid, it is agreed that such offending provision of the Release shall be severed and the balance shall continue in full legal force and effect.

You understand and confirm that by signing this Release, you have given up considerable legal rights and that you have signed this Release freely, voluntarily, under no duress or threat of duress. You also hereby certify that you are 18 years of age or older and are mentally competent to enter into this Agreement.

You hereby represent that you have read, understand and fully agree to the terms of this Release.

I agree to the terms and conditions *

Yes

Timeout Warning

Concrete Safaris Youth Leadership Council Application

What will you gain by being a part of the Concrete Safaris Youth Leadership Council? You will:

We are looking for youth who:

How to apply to be a member of the Concrete Safaris Youth Leadership Council?

Short Answer Section