Volunteer Application/Liability & Confidentiality Forms

Your Contact Information

First Name *

Last Name *

Email *

Address Line 1 *

Address Line 2

Phone *

City *

State *

Zip *

Emergency Contact *

Emergency Contact Phone *

Emergency Contact Email

Church/Civic Organization The maximum length for the field Church/Civic Organization is 500 characters.

Business Name The maximum length for the field Business Name is 500 characters.

Have you ever been convicted of a crime? * The field Have you ever been convicted of a crime? is required.

If yes, please explain: The maximum length for the field If yes, please explain: is 500 characters.

Willing to submit to a background check? * The field Willing to submit to a background check? is required.

Liability Waiver/Confidentiality Agreement

COASTAL CENTER FOR HOPE & HEALING

GENERAL RELEASE OF LIABILITY, ASSUMPTION OF RISK, AND HOLD HARMLESS AGREEMENT

PLEASE READ CAREFULLY BEFORE SIGNING

In consideration of being permitted to participate in activities, programs, services, events, volunteer opportunities, training, meetings, fundraising events, or other functions sponsored, organized, or hosted by Coastal Center for Hope & Healing ("the Agency"), I voluntarily agree to the following:

Release of Liability

I, on behalf of myself, my heirs, executors, administrators, personal representatives, and assigns, hereby release, waive, discharge, and hold harmless Coastal Center for Hope &Healing, its Board of Directors, officers, employees, volunteers, contractors, sponsors, agents, partnering organizations, and affiliates (collectively referred to as the "Released Parties") from any and all claims, demands, causes of action, damages, losses, liabilities, costs, or expenses arising from or relating to my participation in any Agency-sponsored activity, except to the extent caused by gross negligence, reckless misconduct, or intentional wrongdoing where prohibited by applicable law.

This release includes, but is not limited to, claims arising from:

Personal injury;
Illness or disease;
Death;
Property damage or loss;
Accidents;
Transportation associated with Agency activities;
Conditions of facilities or property;
Acts or omissions of participants, volunteers, staff, or third parties.

Assumption of Risk

I understand that participation in Agency activities may involve certain inherent risks that cannot be eliminated regardless of the care taken by the Agency.

These risks may include, but are not limited to:

Slips, trips, and falls;
Physical activity;
Travel to or from Agency activities;
Weather conditions;
Interactions with members of the public;
Use of equipment or facilities;
Other unforeseen hazards.

I voluntarily assume all known and unknown risks associated with my participation.

Medical Authorization

I certify that I am physically able to participate in the activity.

In the event of an illness or injury requiring emergency medical treatment, I authorize Coastal Center for Hope & Healing to obtain emergency medical care on my behalf if I am unable to provide consent.

I understand that I am solely responsible for any medical expenses incurred and that the Agency does not provide medical, accident, or health insurance for participants unless specifically stated otherwise.

Personal Property

I understand that I am responsible for my own personal belongings. Coastal Center for Hope & Healing is not responsible for lost, stolen, or damaged personal property.

Code of Conduct

I agree to conduct myself in a respectful, lawful, and safe manner while participating in Agency activities. I understand that the Agency reserves the right to remove any participant whose behavior is disruptive, unsafe, threatening, discriminatory, or otherwise inconsistent with the Agency's mission and policies.

Photography and Media Release

Coastal Center for Hope & Healing holds the right, title and interest in all photographic images, video or audio recordings made by Coastal Center for Hope & Healing during Volunteer Activities or Events. I understand and agree that these photographs, videos and/or recordings may be used for lawful purposes, including but not limited to:

Marketing and advertising
Social media
Website content
Printed publications
Promotional materials
Educational or informational purposes

I understand that:

I will not receive compensation for the use of these photographs or recordings.
The Photographer/Organization may edit, crop, or otherwise modify the images as needed.
The images may be used indefinitely unless otherwise agreed to in writing.
I release and discharge the Photographer/Organization from any claims arising out of the use of these images, including claims related to privacy, publicity, or copyright.

Confidentiality

I understand that, during participation in Agency activities, I may become aware of confidential information regarding clients, staff, volunteers, donors, or Agency operations.

I agree not to disclose any confidential or identifying information obtained through my participation except as authorized by the Agency or required by law.

Indemnification

To the fullest extent permitted by law, I agree to indemnify and hold harmless the Released Parties from any claims, liabilities, damages, or expenses resulting from my own negligent, reckless, or intentional actions while participating in Agency activities.

Severability

If any provision of this agreement is found to be invalid or unenforceable, the remaining provisions shall remain in full force and effect.

Acknowledgment

By signing below, I acknowledge that:

I have carefully read this agreement.
I understand its contents and legal effect.
I understand that I am giving up certain legal rights.
I sign this agreement voluntarily and without coercion.
I am at least eighteen (18) years of age, or a parent/legal guardian has signed below on my behalf.

I understand that by typing my name, I am electronically signing Coastal Center for Hope and Healing's Liability Waiver and Confidentiality Agreement. This constitutes a legal signature confirming that I acknowledge and agree to the information above.

Your Name The maximum length for the field Your Name is 500 characters.

Today's Date The field Today's Date must be a date.

Minor Liability Waiver

PARENT OR LEGAL GUARDIAN CONSENT (For Participants Under 18)

I certify that I am the parent or legal guardian of the minor participant listed above. I have read this agreement, understand its contents, and consent to the minor's participation. I agree to all terms on behalf of both myself and the minor participant.

I understand that by typing my name, I am electronically signing Coastal Center for Hope & Healing's Release of Liability Waiver and Confidentiality Agreement on behalf of the named minor volunteer. This constitutes a legal signature confirming that I acknowledge and agree to the information above.

Minor's Name The maximum length for the field Minor's Name is 500 characters.

Guardian's Name The maximum length for the field Guardian's Name is 500 characters.

Date The field Date must be a date.