Volunteer Application

Volunteer Application
Name

First Name Last Name
E-mail

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number

- Area Code Phone Number
Are you a Veteran

No Yes

Emergency Contact Information
Name
Relation
Phone
Any medical or allergy we should be aware of?

Volunteer Agreement

Please read the following statements. Please type your full name on the signature line at the end of each statement to indicate you agree with our policies.
I agree not to divulge, publish, or otherwise make known to unauthorized persons or the public any information obtained in the course of using such confidential information, where release of such information may possibly make the person or persons who received such services, or their family, identifiable. I recognize that unauthorized release of confidential information may subject me to civil liability under state law.

Helping Hands Food Bank, its employees, officers and agents shall not be liable for any injury, including death, damages or liability, to any persons and/or agencies for damage to property regardless of how such injury or damages, caused, sustained or alleged to have been sustained by the volunteer or by others as a result of any coordination or occurrence whatsoever related to this project. Helping Hands Food Bank will not be responsible for the loss of wages as a result. It is, therefore, the volunteer’s responsibility to report any injuries promptly to the project coordinator. It is also agreed that the volunteer will follow all laws, safety rules, regulations, and policies as set forth by Helping Hands Food Bank and pertaining to the volunteer job description. If, in fact, a volunteer causes an injury to another volunteer, Helping Hands Food Bank will not be responsible for the conduct of that volunteer or injury of the volunteer who was injured. The volunteer agrees that this release, hold harmless and indemnity agreement shall be binding on this date

I authorize Helping Hands Food Bank to use my images, stories, and quotes for future publications and productions on behalf of Helping Hands Food Bank. I understand I will not receive compensation for the content used. The publicity includes, but is not limited to: articles, newsletters, brochures, social media sites (including Facebook, and HelpingHandsFoodBank.org), and media publicity, including television, radio and newspapers.

OPT OUT of publication of my photo OPT OUT of publication of my story OPT OUT of publication of my name
We value and take seriously the safety of our volunteers and the clients we serve. We have elected to conduct a criminal history and background inquiry on volunteers who will or may have unsupervised access to children under age 16 years of age, developmentally disabled persons, or vulnerable adults. Please fill out our disclosure form and answer the following questions honestly. Information obtained from the background check, including past criminal history, does not automatically restrict you from volunteering. I give permission to Helping Hands Food Bank to complete a background check now, and if needed in the future, while I remain active within the organization. I understand the information will be kept confidential and only used to determine my suitability for the designated volunteer position. I release and hold harmless Helping Hands Food Bank from any and all liability in obtaining personal information for the purpose of a background check.
Date of Signature

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