Volunteer Application

VOLUNTEER INFORMATION

Name

First Name

Middle Name

Last Name

Preferred Name

Vaccination Status

Are you fully vaccinated? You will be asked to email proof of vaccination before you can volunteer.

Contact Information

Preferred Email

Email

Preferred Phone

Mobile Phone

Home Phone

Source

How did you hear about WELD?

Where did you hear about WELD?

Volunteering Interest

Other area(s) of interest

ADDRESS INFORMATION

Mailing Address

Primary Address Type

Street

City

State

Zip/Postal Code

DEMOGRAPHIC INFORMATION

Birthdate

Gender

Ethnicity

Race

Occupation

Employer

At WELD, all of our members have been involved in the legal system and we appreciate volunteers who share that experience. Do you share that experience as well?

SERVICE LEARNING

Do you need service learning hours?

How many hours?

Date you need to have the hours completed by

ACCIDENT WAIVER AND RELEASE FROM LIABILITY

In consideration of my application, and permitting me to volunteer, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A) Waive, Release, and Discharge from any and all liability for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter accrue to me. I acknowledge that participation in volunteer activities carries with it the potential for death, serious injury and property loss. The risks include but are not limited to weather, equipment, actions of other peoples, even/supervisors, organizers, and materials being handled. These risks are inherent within any given volunteer opportunity.

I FULLY ACCEPT AND ASSUME ALL RISKS OF PARTICIPATING IN VOLUNTEERING AT WELD AND ACCEPT PERSONAL RESPONSIBILITY FOR ANY DAMAGES AND EXPENSES ARISING FROM MY PARTICIPATION

I acknowledge that this Accident Waiver and Release from Liability is made for the benefit of WELD.

I will indemnify and hold harmless any and all Releases from any and all liabilities or claims made by other individuals or entities as a result of my action or omissions during my term of volunteering for WELD. I consent to receive emergency medical treatment, which may be deemed necessary in the event of an injury or accident. This Accident Waiver and Release from Liability shall be constructed broadly to provide a release and waiver to the maximum extent under possible applicable law. It shall not be modified in any way. If any part of this Accident Waiver and Release from Liability is determined invalid by law, all other parts of this waiver shall remain valid and enforceable.

I agree to the terms of the Accident Waiver and Release of Liability

Today's Date

Printing your name here will indicate you understand and agree to the terms above

AUTHORIZATION FOR USE AND RELEASE OF PHOTOS, AUDIO CLIPS, & VIDEOS

The undersigned, being of legal age, does hereby agree and consent that WELD its successors, legal representatives and assigns may use and reproduce my name, photograph and/or movie film, video tape recordings or audio tape recordings of myself, and circulate, use, publish, broadcast and otherwise distribute the same for any and all purposes including advertising, publications and other purposes of trade without limitation and/or compensation to me. The agreement also includes the same authorization for my minor children, if applicable, and includes permission to quote all or part of my statement on the reverse side of this release (with the privilege of editing or rearranging but not changing the original meaning).

I agree to the terms of the Authorization for use and Release of Photos, Audio Clips, & Video

Today's Date

Printing your name here will indicate you understand and agree to the terms above