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Welcome to the Meals on Wheels of Metro Tulsa Community Event Registration & Volunteer Information System (CERVIS). Thank you for your desire to serve as part of the Meals on Wheels of Metro Tulsa team. Please complete the information requested below to submit your application for review. We look forward to serving with you!


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Volunteer First Name:*
Volunteer Last Name:*
Volunteer Primary Phone:*
 
Volunteer E-mail:*
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Volunteer Address:
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Volunteer Birth Date:*
Emergency Contact Name:*
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How often would you like to volunteer?:*
Do You Have License & Insurance?:*
Would you like to coordinate other volunteers?:*
How did you hear about us?:*
Volunteer T-Shirt Size:*
Employer Name:
Do you have a smartphone or mobile device with a touch screen?:*
Have you traveled out of the country in the past 60 days?:*
Have you traveled outside of Oklahoma in the past 30 days?:*
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In consideration of the risk of injury while participating in Food Delivery (the “Activity”), and as consideration for the right to participate in the Activity, I hereby, for myself, my heirs, executors, administrators, assigns, or personal representatives, knowingly and voluntarily enter into this waiver and release of liability and hereby waive any and all rights, claims or causes of action of any kind whatsoever arising out of my participation in the Activity, and do hereby release and forever discharge Meals on Wheels of Metro Tulsa, located at 12620 East 31st Street, Tulsa, OK 74146, its affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns, for any physical or psychological injury, including but not limited to illness, paralysis, death, damages, economical or emotional loss, that I may suffer as a direct result of my participation in the aforementioned Activity including traveling to and from an event related to this Activity. I AM VOLUNTARILY PARTICIPATING IN THE AFOREMENTIONED ACTIVITY AND I AM PARTICIPATING IN THE ACTIVITY ENTIRELY AT MY OWN RISK. I AM AWARE OF THE RISKS ASSOCIATED WITH TRAVELING TO AND FROM AS WELL AS PARTICIPATING IN THIS ACTIVITY, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO, PHYSICAL OR PSYCHOLOGICAL INJURY, PAIN, SUFFERING, ILLNESS, DISFIGUREMENT, TEMPORARY OR PERMANENT DISABILITY (INCLUDING PARALYSIS), ECONOMIC OR EMOTIONAL LOSS, AND DEATH. I UNDERSTAND THAT THESE INJURIES OR OUTCOMES MAY ARISE FROM MY OWN OR OTHERS’ NEGLIGENCE, CONDITIONS RELATED TO TRAVEL, OR THE CONDITION OF THE ACTIVITY LOCATION(S). NONETHELESS, I ASSUME ALL RELATED RISKS, BOTH KNOWN AND UNKNOWN TO ME, OF MY PARTICIPATION IN THIS ACTIVITY, INCLUDING TRAVEL TO, FROM AND DURING THIS ACTIVITY. I agree to indemnify and hold harmless Meals on Wheels of Metro Tulsa against any and all claims, suits or actions of any kind whatsoever for liability, damages, compensation or otherwise brought by me or anyone on my behalf, including attorney’s fees and any related costs, if litigation arises pursuant to any claims made by me or by anyone else acting on my behalf. If Meals on Wheels of Metro Tulsa incurs any of these types of expenses, I agree to reimburse Meals on Wheels of Metro Tulsa. I acknowledge that Meals on Wheels of Metro Tulsa and its directors, officers, volunteers, representatives and agents are not responsible for errors, omissions, acts or failures to act of any party or entity conducting a specific event or activity on behalf of Meals on Wheels of Metro Tulsa. I acknowledge that this Activity may involve a test of my physical and mental limits and may carry with it the potential for death, serious injury, and property loss. The risks may include, but are not limited to, those caused by terrain, facilities, temperature, weather, lack of hydration, condition of participants, equipment, vehicular traffic and actions of others, including but not limited, participants, volunteers, spectators, coaches, event officials and event monitors, and/or producers of the event. I ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS “WAIVER AND RELEASE” AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. I EXPRESSLY AGREE TO RELEASE AND DISCHARGE Meals on Wheels of Metro Tulsa AND ALL OF ITS AFFILIATES, MANAGERS, MEMBERS, AGENTS, ATTORNEYS, STAFF, VOLUNTEERS, HEIRS, REPRESENTATIVES, PREDECESSORS, SUCCESSORS AND ASSIGNS, FROM ANY AND ALL CLAIMS OR CAUSES OF ACTION AND I AGREE TO VOLUNTARILY GIVE UP OR WAIVE ANY RIGHT THAT I OTHERWISE HAVE TO BRING A LEGAL ACTION AGAINST Meals on Wheels of Metro Tulsa FOR PERSONAL INJURY OR PROPERTY DAMAGE. To the extent that statute or case law does not prohibit release for negligence, this release is also for negligence on the part of Meals on Wheels of Metro Tulsa, its agents, and employees. In the event that I should require medical care or treatment, I agree to be financially responsible for any costs incurred as a result of such treatment. I am aware and understand that I should carry my own health insurance. In the event that any damage to equipment or facilities occurs as a result of my or my family's willful actions, neglect, or recklessness, I acknowledge and agree to be held liable for any and all costs associated with any actions of neglect or recklessness. This Agreement was entered into at arm's-length, without duress or coercion, and is to be interpreted as an agreement between two parties of equal bargaining strength. Both myself (see below) and Meals on Wheels of Metro Tulsa agree that this Agreement is clear and unambiguous as to its terms, and that no other evidence will be used or admitted to alter or explain the terms of this Agreement, but that it will be interpreted based on the language in accordance with the purposes for which it is entered into. In the event that any provision contained within this Release of Liability shall be deemed to be severable or invalid, or if any term, condition, phrase or portion of this agreement shall be determined to be unlawful or otherwise unenforceable, the remainder of this agreement shall remain in full force and effect, so long as the clause severed does not affect the intent of the parties. If a court should find that any provision of this agreement to be invalid or unenforceable, but that by limiting said provision it would become valid and enforceable, then said provision shall be deemed to be written, construed, and enforced as so limited.


Additional Terms of Service

By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application could invalidate my participation in the program. The undersigned authorizes MOWMT to secure any information from sources referred to or inferred herein or sources which the agency deems necessary to evaluate the undersigned potential as a MOW volunteer, including criminal background checks. All information will be held in strict confidence. The undersigned acknowledges and agrees that 1) he/she is not obligated, if called upon, to perform the volunteer services herein applied for and that the agency is not obligated to assign or place the undersigned to a volunteer position and 2) further training, orientation, and reading may be required by the agency before placement. I give permission for photos and videos of me during the course of volunteering for MOW.