Volunteer Application/ Waiver release form

Our organization encourages the participation of volunteers who support our mission. If you agree with our mission, we encourage you to complete this application. The information on this form will be kept confidential and will help us find the most satisfying and appropriate volunteer opportunity for you.

Name: ________________________________________________________________________

Address: ______________________________________________________________________

City: ______________________________ State: _______________ Zip: __________________

Phone: ____________________________ Email: _____________________________________

Employer: ____________________________________ Position: ________________________

Any special talents or skills you have that you feel would benefit our organization? __________

______________________________________________________________________________

Please indicate days available to work:  Mon__ Tues __ Wed __ Thur __ Fri __ Sat __ Sun__

Times available:  From _______________________ to:   _______________________________

Any physical limitations: _________________________________________________________

______________________________________________________________________________

In case of an emergency contact: ___________________________________________________

Volunteer understand that the scope of Volunteer’s relationship with S.E.E.K., Inc., is limited to a volunteer position and that no compensation is expected in return for services provided by Volunteer; that this nonprofit will not provide any benefits traditionally associated with employment to Volunteer; and that Volunteer is responsible for his/ her own insurance coverage in the event of personal injury or illness as a result of Volunteer’s services to S.E.E.K., Inc.

1.          Wavier and Release: I, the volunteer, release and forever discharge and hold S.E.E.K., Inc.,  and its successors from any and all liability claims and demands of whatever kind or nature, either in law or in equity, which arise or may hereafter arise from the services I provide to S.E.E.K., Inc. I release this nonprofit from any liability or claim that I may have against this nonprofit with respects to bodily injury, personal injury, illness, death, or property damages that may result from services I provide to the nonprofit or occurring while I am providing volunteer services.

 

2.          Insurance: Further, I understand that S.E.E.K., Inc., does not assume any responsibility for or obligation to provide me with financial or other assistance, including but not limited to medical, health or disability benefits or insurance of any nature in the event of my injury, illness, death or damage to my property. I expressly waive any such claim for compensation or liability on the part of S.E.E.K., Inc., beyond what may be offered freely by this nonprofit in the event of such injury or medical expenses incurred by me.

 

3.          Medical Treatment: I hereby Release and forever discharge S.E.E.K., Inc., from any claim whatsoever which arises or may hereafter arise on account of any first-aid treatment or other medical services rendered in connection with an emergency during my tenure as a volunteer with S.E.E.K., Inc.

 

4.          Assumption of Risk: I understand that the services I provide to S.E.E.K., Inc., may include activities that may be hazardous to me including, but not limited to construction work or inherently hazardous activities. As a volunteer, I hereby expressly assume the risk of injury or harm from these activities and release S.E.E.K., Inc., from all liability for injury, illness, death, or property damage resulting from services I provide as a volunteer or occurring while I am providing volunteer services.

 

5.          Photographic Release: I grant and convey S.E.E.K., Inc., to all rights, title, and interests in any and all photographs, images, video, or audio recording of me or my likeness or voice made by S.E.E.K., Inc., in connection with providing volunteer services to S.E.E.K., Inc.

 

6.          Orderly Conduct:  I hereby will conduct myself in an appropriate manner when volunteering for S.E.E.K., Inc. I will show respect for individuals from all walks of life.  I will not indulge in the use of inappropriate language, alcoholic beverages and or volunteer under the influence of alcohol or paraphernalia as I provide volunteer services for S.E.E.K., Inc.

By signing below, I express my understanding and intent to enter into this Release and Waiver of Liability willingly and voluntarily.

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