Food & Health Network Farm to School Taste Test Volunteer Sign-Up Form
Contact us at (607) 692-7669 or
Email address *
Name *
Phone number
What days are you interested in volunteering? *
Volunteer Agreement
As a volunteer of Rural Health Network of South Central New York:

I recognize that I represent Rural Health Network (RHN) to the public. I accept this responsibility and will conduct myself in a professional manner during my volunteer service. I understand that, for safety reasons, I cannot wear open toed shoes while volunteering in a school and that my clothes may get dirty while volunteering in the kitchen and cafeteria. I also understand that clothes should be professional and appropriate for a school setting. The Rural Health Network is not responsible for lost or stolen items.

I agree to show up on time and stay for the entire volunteer event whenever I make a volunteer service commitment to Rural Health Network. I agree to provide as much advance notice as possible in the event that I will be absent from my volunteer shift. I additionally agree to maintain the confidentiality of all clients, volunteers, agency staff, donors, RHN staff members, students, and other individuals about whom I may have personal and identifying information. I will not disclose any information I may hear about clients, volunteers, agency staff, donors, RHN staff members, students or other individuals during my service with the Rural Health Network.

I understand and acknowledge that injuries may result during my volunteer activities not only from my own actions,
but also may be caused by the negligence or actions of others. I voluntarily assume all of the risks of and accept
personal responsibility for all damages and losses which may result during my activities as a volunteer with Rural Health Network. I hereby release, waive, discharge and covenant not to sue Rural Health Network of South Central New York or any of its directors, employees, agents, representatives, successors, volunteers and assigns, and to indemnify and hold them harmless from any and all liability, loss, or damages of any kind or of any nature caused by, resulting from, or related in any way to my volunteer activities for Rural Health Network.

I understand that Rural Health Network may photograph or video tape events or activities while I am volunteering. I give permission to Rural Health Network to use photographs, audio or video recordings of me performing volunteer work for the purpose of promoting Rural Health Network, as well as, to use my image, likeness or voice in their public communications and/or media without payment or compensation.

I have read and agree to the terms laid out in the volunteer agreement found above: *
A copy of your responses will be emailed to the address you provided.
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