2011 build volunteer app and waiver

2011 Build Volunteer Application Form Thank you for your interest in Habitat for Humanity Windsor-Essex. The information you provide will help us place you in a volunteer position which best suits your interests & skills, as well as the needs of the build.CONTACT INFORMATION Date of application:Last name: First name:Street Address: Apt. #City: Province: Postal Code:Home Telephone: Other or Preferred Telephone: i.e. cell, workEmergency contact: Full Name Relationship Contact numberE-mail address: Are you 18 yrs of age or older Yes □ No □Team name if volunteering as a group or with an organization or company:AVAILABILITY When are you available to begin volunteering? ___________________________________________________Please indicate your preferred days and times to volunteer below. Monday Tuesday Wednesday Thursday Friday Saturday AM □ AM □ AM □ AM □ AM □ AM □ PM □ PM □ PM □ PM □ PM □ PM □ Availability Frequency Weekly □ Bi-Weekly □ Monthly □ On Call □REFERENCES Name Contact NumberCOMMENTS (may include anything relevant such as previous work/volunteer experience(s), physical limitations, or if you are with a group)____________________________________________ ______________________________________ SIGNATURE DATEThere are four ways to submit your application: 1. Via mail to HABITAT FOR HUMANITY WINDSOR-ESSEX INC, 3064 Devon Dr., Windsor, ON N8X 4L2.2. Deliver in person to 3064 Devon Drive. 3. Fax to 519-969-7832. 4. Scan and email to office@habitatwindsor.org

RELEASE WAIVER AND LIABILITY – 2011THIS RELEASE AND WAIVER OF LIABILITY (the 6. Other: The Volunteer expressly agrees that this Release“Release”) executed on this ______ day of ________________, is intended to be as broad and inclusive as permitted by the2011, by_____________________________(the “Volunteer”) laws of the country of Canada, and that this Release shallin favour of Habitat for Humanity Windsor-Essex, Inc., a be governed by and interpreted in accordance with the lawsCanadian non-profit corporation (“Habitat”), its directors, of the country of Canada. The Volunteer agrees that in theofficers, employees, and agents. The Volunteer desires to event that any clause or provision of the Release shall beparticipate in a Habitat build project and all related activities. held to be invalid by any court of competent jurisdiction,The Volunteer understands that the activities include that invalidity of such clause or provision shall notpreparation and construction or renovation of residential otherwise affect the remaining provision of this Release,buildings and surrounding property, salvage and demolition which shall continue to be enforceable.projects, working in the Habitat offices, being transported toand from the work site and consuming food provided by local 7. Expiration Date: One year from date of signingpeople and organizations. The Volunteer does hereby freely,voluntarily, and without duress execute this Release under the 8. Safety: The Volunteer is aware that they need to providefollowing terms: his/her own CSA certified steel-toed safety shoes and wear appropriate clothing. Wearing of contact lenses on the1.Waivers and Release: Volunteer does hereby release and build site is not recommended.forever discharge and hold harmless Habitat and its successorsand assigns from any and all liability, claims and demands of 9. Privacy Policy: Personal information gathered bywhatever kind of nature either in law or equity, which arise or Habitat for Humanity Windsor-Essex Inc. is kept inmay hereafter arise from Volunteer’s participation in Habitat’s confidence. Our personnel are authorized to accessproject. Volunteer understands that this Release discharges personal information based only on their need to deal withHabitat from any liability or claim that the volunteer may have the information for the reason(s) for which it was obtained.against Habitat with respect to any bodily injury, personal Safeguards are in place to ensure that the information is notinjury, illness, death, or property damage that may result from disclosed or shared more widely than necessary to achieveVolunteer’s participation in Habitat’s project. Volunteer also the purpose for which it was gathered. We also takeunderstands that Habitat does not assume any responsibility or measures to ensure the integrity of this information isobligation to provide financial assistance or other assistance, maintained and to prevent its being lost or destroyed. Weincluding but not limited to medical, health, or disability collect, use, and disclose personal information only forinsurance. purposes that a reasonable person would consider appropriate in light of the circumstances. We routinely2. Medical Treatment: Volunteer does hereby release and offer individuals we deal with the opportunity to opt not toforever discharge Habitat from any claim whatsoever which have their information shared for purposes beyond thosemay arise or may hereafter arise on account of any first aid, for which it was explicitly collected. Questions, concernstreatment or service rendered in connection with the or complaints relating to Habitat for Humanity Windsor-Volunteer’s participation in the Habitat project. Essex Inc.’s privacy policy on the treatment of personal information should be sent to office@habitatwindsor.org3. Assumption of Risk: The volunteer understands that theHabitat project may include activities that may be hazardous to IN WITNESS WHEREOF, the Volunteer has executedthe Volunteer and that the food, accommodations, and medical this Release as of the day and year first written above.facilities may be donated to Habitat and beyond the control ofHabitat. The Volunteer hereby expressly and specifically Volunteer Witness (important)assumes the risk of injury or harm in their activities andreleases Habitat from all liability from injury, illness, death, or -property damage resulting from the activities of the Volunteer’s (Print) (Print)participation in Habitat’s project.4. Insurance: The Volunteer understands that Habitat does not (Signature) (Signature)carry or maintain health, medical, or disability insurancecoverage for any Volunteer. Each Volunteer is expected andencouraged to arrive with medical or health insurance coverage (Date) (Date)in effect.5. Photographic Release: The Volunteer does hereby grant IN CASE OF EMERGENCY, CONTACT:and convey unto Habitat all right, title and interest in any andall photographic images and video or audio recordings made by Name:_____________________ Phone:______________Habitat during Habitat’s project including, but not limited to,any royalties proceeds, or other benefits derived from such Relationship: ___________________________________photographs or recording.

2011 build volunteer app and waiver

by Habitat for Humanity Windsor-Essex Inc. on Jun 11, 2011

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2011 build volunteer app and waiver — Document Transcript