Volunteer Information

Home Delivered Groceries Volunteer Application

* Required Fields

Contact Information

First Name

Last Name

Address

Address 2

City

State/Province

Zip/Postal Code

Cell Phone

Emergency Contact Information

Volunteer Information

Primary Language Spoken:

Do you speak any additional languages?

How did you hear about us?

Are you able to commit to volunteering on a regular basis?

Are you available Tuesdays between 3:00 and 6:00 pm?

Are you available Thursdays between 2:30 and 6:00 pm?

What is the typical time frame you will be making your delivery?

Additional Notes:

VOLUNTEER AGREEMENT & GENERAL RELEASE OF LIABILITY

As a volunteer, I understand that I will earn no wages or benefits & will not be entitled to unemployment insurance benefits as a result of this service.

I am aware that participation as a volunteer may require periods of physical requirements. I am voluntarily participating in this activity & agree to accept any and all risks of personal injury and property damage.

As a consideration for volunteering with the organization, I hereby agree that I, my assignees, heirs, guardians & legal representatives, will not make a claim against or sue The Richmond Neighborhood Center or its employees, agents, volunteers, or contractors for injury or damage resulting from the negligence, whether active or passive, or other acts, however caused, by any of its officers, employees, agents or contractors of The Richmond Neighborhood Center as a result of my volunteering.

I understand that I am not covered by The Richmond Neighborhood Center’s Workers Compensation Insurance. I and/or my personal medical insurance will assume responsibility for the expenses of any medical treatment as a result of my volunteering.

If I am unable to act for myself, I authorize The Richmond Neighborhood Center to seek emergency medical treatment on my behalf in case of injury, accident or illness to me arising from my involvement as a volunteer.

I understand that the materials and tools provided are and remain the property of The Richmond Neighborhood Center & I agree to return these tools and any remaining materials at the end of my volunteer service.

I give The Richmond Neighborhood Center permission to use photographs or videotapes in which I appear for publicity or business purposes.

BY TYPING MY NAME BELOW, I ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY, AND SIGN IT OF MY OWN FREE WILL.

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