Volunteer Registration Form
Please complete this form every season you are volunteering with EMR.
Email address *
First name *
Your answer
Surname *
Your answer
Cellphone number *
Your answer
Dietary Requirements *
Medical Conditions?
Please elaborate on medical conditions
Your answer
Emergency contact details
Please use someone that is local
Name *
Your answer
Relationship *
Your answer
Contact phone number *
Your answer
What region(s) are you interested in volunteering in? *
Required
Have you volunteered with EMR before? *
If so, in what capacity?
Your answer
What relevant work experience/qualifications do you have? *
Your answer
Skills/Experience - Select those which apply *
Required
Do you have any of the following qualifications?
Do you have any criminal convictions? *
If yes, please elaborate
Your answer
Drug and alcohol policy
By signing this form you agree to abide by MTSCT - EMR’s drug and alcohol policy which includes not being under the influence of drugs or alcohol when onsite or involved in MTSCT - EMRs activities and safety sensitive sites. f
Volunteers
The volunteer will be responsible for his/her own transport to and from the place of work. The volunteer will be given access to the relevant RAMS form/s for the site and given a full Health and Safety briefing from the supervisor. The volunteer reserves the right to refuse work if he/she feels harassed or unfairly treated or unsafe.

The Trust reserves the right to cancel this agreement if the volunteer does not fulfil his/her obligations eg doesn’t turn up to work, harasses the supervisor, refuses to work, and demonstrates unsafe practices.

During work the volunteer must ensure all Trust protocols are adhered to or he/she is liable to be refused further positions for the Trust.

Risk Disclosure
Health and Safety policies and SOP’s are found on our programme websites. On the day volunteers will be given access to the relevant RAMS form/s or event plans for the site and given a full Health and Safety briefing from the supervisor, including (but not limited to) the identification of potential risks and management strategies. Volunteers will be verbally briefed about the work to be undertaken and potential hazards, location of first aid, facilities and emergency procedures on the commencement of every activity. Site familiarisation is undertaken and relevant issues explained wherever these arise.

Complaints procedure is to advise the Trust Chairperson of any complaints or concerns, which will be dealt with by the Trust. Feedback and/or complaints can also be submitted via our website
http://www.emr.org.nz/information.php?info_id=190

The volunteer will be provided with a reference from the trust outlining duties undertaken during term of work.

Liability Statement
I accept that any medical costs associated with accidents are to be classified as nonwork related and will be paid for by the ACC or other means and under no circumstances by the (Mountains to Sea Conservation Trust). (The Mountains to Sea Conservation Trust) does not accept any responsibility whatsoever for any personal accident or loss/damage to personal items or equipment for volunteers whilst they are engaged in the project.
Volunteer Declaration
In entering your name and date below you understand the risks and liability outlined above.
Your full name *
Your answer
Date *
MM
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DD
/
YYYY
A copy of your responses will be emailed to the address you provided.
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