Volunteer Release & Waiver of Liability
Please fill out the following form upon your first visit to DESK as a volunteer. Thank you!
First Name *
Last Name *
Date of Birth *
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DD
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Street Address / Apt. No.
City
State (two-letter abbreviation)
Zip Code (five digits)
Phone Number *
Please enter your phone number without any dashes or parentheses.
E-mail Address
Emergency Contact Name *
Emergency Contact Phone Number *
Court Appointed? *
If yes, are your court-appointed hours related to a violent crime of any kind? *
School Credit? *
How did you hear about DESK? (Check all that apply.) *
Required
Did you sign up online via SignUp.com? *
If you are completing this form on behalf of others, please list names below.
Please read the following and type your initials at the bottom. *
I hereby certify that (1) I am at least 18 years of age, or if not, a parent or guardian has given approval (below); (2) I recognize and appreciate any dangers/risks inherent in volunteering with Downtown Evening Soup Kitchen; (3) I am submitting this release a valid waiver of liability declaration voluntarily and of my own free will; (4) I have made DESK staff aware of any impairments that would hinder my ability to volunteer including any current illness or potential ability to spread infectious disease and I hereby assure that, to the best of my knowledge, I am not exhibiting symptoms of any infectious or communicable disease and that I am in good physical health; (5) I hold harmless and agree to indemnify Downtown Evening Soup Kitchen, its officers, directors, employees, agents, volunteers, and clients from all claims, liability, and damages I may sustain from any bodily injury or exposure to communicable disease, personal injury or property damage which may occur from any cause, including negligence, before, during or after any Downtown Evening Soup Kitchen event in which I participate as a volunteer; (6) I irrevocably grant Downtown Evening Soup Kitchen and its agents, the right to use my name, likeness, photos, or reproduction for the purposes of promoting the cumulative work carried out by the agency in support of the clients; (7) I agree not to use any multimedia recording devices to capture audio or visual information on DESK's clients or to share any multimedia outside the agency that might serve to defame DESK, its clients, its volunteers, or its staff; (8) I have been made aware of my rights as a volunteer; (8) I acknowledge that I have read and understand this entire Waiver of Liability and Release, and I agree to be legally bound by it. Not only does Downtown Evening Soup Kitchen not discriminate on the basis of gender, race, ethnicity, sexual orientation, religion, or lifestyle choice, but we actively value and promote the role of diversity and encourage volunteer participation from people of all backgrounds. This value imbues the work we do at all levels.
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