This question requires a valid date format of MM/DD/YYYY.
This question requires a valid number format.
Please list the other individuals (including minors) that are part of your household and their ages (adults over 18 may be subject to a background check).
I certify that I am currently maintaining Motor Vehicle Liability Insurance and carry a minimum of $100,000 per person, $300,000 per accident and $100,000 property damage or $300,000 combined single limit. In the event that such insurance is terminated or canceled for any reason, I agree to promptly notify SpringSpirit. I also agree not to operate a vehicle in connection with my child I am matched with until my insurance is reinstated.
I agree that my insurance will be the sole and primary insurance coverage in the event of an accident while transporting my SpringSpirit mentee. I agree to operate the vehicle in as safe and legal manner as possible while transporting my SpringSpirit mentee.
By signing below, I certify that all information given on this application is true and complete to the best of my knowledge. I know that by completing this application I am not automatically accepted as a mentor for a child. I also agree to the following guidelines:
1. I will hold confidential all information that I obtain directly or indirectly concerning children and their families.
2. My time is donated as a volunteer mentor to a child who is a member of SpringSpirit.
3. I will make my best effort to be on time, be conscientious, conduct myself professionally, and be courteous and considerate of others at all times.
4. I will not hold SpringSpirit responsible for any accidents or injuries that may occur while I am with my child.