Create Volunteer Profile



Thank you for registering to volunteer with Hands4Hope – Youth Making A Difference.  In order to coordinate participation in Hands4Hope activities, we need to collect and store some information about each volunteer. This information is used only for management of volunteers for Hands4Hope related events and outreaches, and will not be shared with any other organizations. Authorized Hands4Hope adult volunteers may access the information you provide. (Authorized adults are fingerprinted and have completed a youth protection-training course.)

 

All family members who plan to volunteer for Hands4Hope related events are required to fill out a separate registration form. (One form per person)

 

Please allow up to 48 hours for your profile to be activated. Once you receive email notification of your profile activation, you will be able to select and register for an event.


* Indicates a required field
Volunteer Last Name:*
Volunteer First Name:*
Volunteer Primary Phone:*
Volunteer E-mail:*
Confirm E-mail:*
Volunteer Alternate Phone:
Volunteer Address:*
Volunteer Address Line 2:
Volunteer City/Town:*
Volunteer State:*
Volunteer Zip Code:*
Emergency Contact Name:*
Emergency Contact Phone:*
Parent/Guardian #1 Full Name, Cell Phone & Email (required for youth volunteers):*
Parent/Guardian #1 Employer/Occupation (optional):
Parent/Guardian #2 Full Name & Cell Phone & Email:
Parent/Guardian #2 Employer/Occupation (optional):
Annual Household Income (optional):*
Photo Release Notes: (1000 character max)
Grade Level - if you are an adult, select 'adult'.:*
Ethnicity/Race:*
Do you have medical conditions or take medications you want us to know about? Please explain :
In case of emergency, who is your preferred medical provider?:*
How did you hear about Hands4Hope?:*
What is the primary reason you are volunteering with Hands4Hope?:*
Volunteer Birth Date:
Volunteer Interests:
Volunteer Groups:

TERMS & CONDITIONS

On behalf of myself, I waive any right, claim, claim of responsibility or liability, or cause of action arising as a result of my participation as a volunteer with the Organization from which any liability may or could accrue against the Organization or its officers, directors, employees, or representatives, collectively or individually. Without limiting the generality of the above, I agree that this waiver shall include any rights, claims, claims of responsibility or liability or causes of action resulting from personal injury or damage to my property sustained in connection with my activities with the Organization; and agree to indemnify the Organization and its officers, directors, employees, or representatives, collectively or individually, from any such claims.

VOLUNTEER WAIVER, RELEASE, AND INDEMNITY AGREEMENT

1. Acknowledges that the undersigned's participation in the Event may include activities that may be hazardous to the undersigned and assumes the risk of injury or harm associated with such participation.

2. Releases and forever discharges the Sponsor and its employees, officers, directors, shareholders, affiliates, agents, representatives, successors and assigns (collectively the "Releasees") of and from all liability, claims, demands, damages, costs, expenses, actions and causes of action (collectively the "Claims") in respect of death, injury, loss or damage to myself or property howsoever caused, arising or to arise by reason of or during my participation in the Event, whether prior to, during or subsequent to my attendance and notwithstanding that any Claim may have been contributed to or occasioned by the negligence of any of the Releasees.

3. Indemnifies and saves harmless the Releasees from and against any and all liability incurred by any or all of them arising as a result of or in any way connected to my participation in the Event.

4. Understands and acknowledges that the Sponsor does not carry or maintain health, medical or disability insurance coverage for the undersigned and therefore agrees to assume responsibility for such insurance coverage on the undersigned.

5. Agrees that in the event that any provision of this Release and Indemnity is held to be invalid or unenforceable by any court of competent jurisdiction, the invalidity or unenforceability of such provision will not affect the remaining provisions of this Release and Indemnity which shall continue to be enforceable.

EMERGENCY RELEASE

If, in the judgment of the staff and volunteers of Hands4Hope – Youth Making A Difference, the child named needs immediate care and treatment as a result of any injury or sickness, I hereby give permission to the staff and volunteers to secure proper treatment for my child. I do hereby consent to whatever x-ray, examination, anesthetic, medical, surgical or dental diagnosis or treatment and hospital care are considered necessary in the best judgment of the attending physician, surgeon or dentist and performed by or under the supervision of the medical staff of the hospital or facility furnishing medical or dental services. It is further understood that the undersigned will assume full responsibility for any such action, including payment of costs.  I do hereby agree to indemnify and hold harmless Hands4Hope (including its officers, directors, members and/or volunteers) from any claim by any person whomsoever on account of such care and treatment of said child.

PHOTO/VIDEO RELEASE

I give permission to Hands4Hope – Youth Making A Difference to use photographs, and/or video, and/or audio of me obtained while participation as a volunteer with the Organization. I release the Organization from any and all liabilities arising from the use of these items for publicity purposes and waive the right to all negatives, photos, tapes and reproductions, as well as waive my right to inspect or approve the finished photographs an/or tapes.

BASIC PRINCIPLES OF CONFIDENTIALITY:

1. Clients have a right to the protection of confidential information about themselves.

2. The volunteer shares information about a client only with the volunteer’s lead, the Volunteer Coordinator or other appropriate Hands4Hope – Youth Making A Difference staff members.

3. A volunteer will not communicate confidential information to anyone outside the Organization.

4. Speaking of your volunteer assignment in general terms, avoiding use of any client names, is NOT a breach of confidentiality.

CONFIDENTIALITY STATEMENT OF UNDERSTANDING

Confidentiality or the protection of children’s and/or adult’s rights is an important tool in the treatment of the groups we work with through our programs.  Under no circumstances will the names of the children or adults, their problems, their conversations with volunteers, their personal or family background be discussed with anyone outside of Hands4Hope.  This prohibition includes discussions with other volunteers and staff who are not directly servicing the families/children/adults we are serving.

Volunteers seeking to gather or share information must first obtain a written release of confidentiality that is signed by a responsible adult directly related to the child, Hands4Hope, the organization we are partnering with (i.e. Mercy Housing), or the family.  The accumulation of information or information sharing must only take place with the supervision of a Hands4Hope director and must be directly related to the services performed in the capacity of a volunteer with Hands4Hope.

If a youth/adult wants to share information with you but requests that you not share it with anyone else, it is a good practice to inform the youth/adult that you may need to share it with the Hands4Hope executive director.  Then it is up to the youth to determine if he or she wishes to continue the conversation.  This practice will protect you from manipulation on the part of the youth and protect the youth from a breach of confidentiality by you.

I agree that authorized Hands4Hope adult volunteers may use the information I provide.  (Authorized adults are fingerprinted and have completed a youth protection-training course)