Thank you for your interest in becoming a volunteer for the Williamson County Medical Reserve Corps.

An entry is required for any field that is followed by an asterisk.

Once you complete the form, click the Continue button at the bottom.

The WilCo MRC coordinator will reach out to you with next steps.


Name, Address, Contact Information


Background Check Information

(This section does not apply to high school students; completion is not required) An authorization to conduct a criminal history check is required of all Williamson County Medical Reserve Corps (WilCo MRC) volunteers. The information provided below will be used solely to determine eligibility for service as a volunteer. Your completion of the form in its entirety authorizes WCCHD Human Resources to conduct investigation inquires into police records, the state prison system, the Department of Public Safety, and/or any other criminal records to determine your acceptability for volunteer work. Failure to clear the criminal history record may disqualify you to serve as a volunteer for WilCo MRC.



Education, Skills and Medically Related Licenses


Email Preferences

We like to keep volunteers informed of important news, schedules, and volunteer opportunities by email, however will not send you any email you prefer not to receive. Use the checkboxes below to select the kinds of email you would like to receive from us.



Medical Reserve Corps Interests


Release and Indemnity Agreement's

WILLIAMSON COUNTY AND CITIES HEALTH DISTRICT RELEASE AND INDEMNITY AGREEMENT

This Agreement is entered into by the below named and undersigned person (“Volunteer”).

RECITALS The Williamson County and Cities Health District (the “District”) is a public health district that provides public health services to the residents of Williamson County, Texas and the Member Cities of the District. Volunteer is interested in assisting and participating in the distribution and administration of COVID-19 vaccines within Williamson County (the “Public Health Activities”). Volunteer’s participation in the Public Health Activities is voluntary and without compensation. Volunteer acknowledges that health risks and physical safety risks may be present at a COVID-19 vaccine point of dispensing, including, without limitation, exposure to coronavirus disease, crowded premises, drive-through operations, and exposure to weather.

RELEASE AND INDEMNITY AGREEMENT In consideration of the District permitting Volunteer to participate in the Public Health Activities, Volunteer agrees to release and indemnify the District, its directors, officers, and employees (each, an “Indemnified Party”) with respect to any and all claims or causes of action, arising in whole or in part from the Public Health Activities, for personal injuries or damage to property, REGARDLESS IF THE CLAIM OR CAUSE OF ACTION IS CAUSED BY THE NEGLIGENCE OF AN INDEMNIFIED PARTY.

WILLIAMSON COUNTY AND CITIES HEALTH DISTRICT COVID-19 RELEASE AND INDEMNITY AGREEMENT This Agreement is entered into by the below named and undersigned person (“Volunteer”).

RECITALS The Williamson County and Cities Health District (the “District”) is a public health district that provides public health services to the residents of Williamson County, Texas and the Member Cities of the District. Volunteer is interested in assisting and participating in the distribution and administration of COVID-19 vaccines within Williamson County (the “Public Health Activities”). Volunteer’s participation in the Public Health Activities is voluntary and without compensation. Volunteer acknowledges that health risks and physical safety risks may be present at a COVID-19 vaccine point of dispensing, including, without limitation, exposure to coronavirus disease, crowded premises, drive-through operations, and exposure to weather.

RELEASE AND INDEMNITY AGREEMENT In consideration of the District permitting Volunteer to participate in the Public Health Activities, Volunteer agrees to release and indemnify the District, its directors, officers, and employees (each, an “Indemnified Party”) with respect to any and all claims or causes of action, arising in whole or in part from the Public Health Activities, for personal injuries or damage to property, REGARDLESS IF THE CLAIM OR CAUSE OF ACTION IS CAUSED BY THE NEGLIGENCE OF AN INDEMNIFIED PARTY.


AUTHORIZATIONS

I authorize the Williamson County Medical Reserve Corps (WilCo MRC) to conduct a criminal history record check as required by the Williamson County and Cities Health District.

By checking the box below, I authorize WilcoMRC and/or WCCHD to use, reproduce, and/or publish photographs and/or video that may pertain to me-- including my image, likeliness and/or voice without compensation. I understand that this material may be used in various publications, public affairs releases, recruitment materials, broadcast public service advertising (PSAs) or for other related endeavors. This material may also appear on the WilcoMRC and/or WCCHD web pages. WilcoMRC and/or WCCHD may publish materials, use my name, photograph, and/or reference me in any manner that may be deemed appropriate in order to promote/publicize public health services and volunteer opportunities.

Risk Waiver: The Williamson County and Cities Health District (WCCHD) and the Williamson County Medical Reserve Corps (WilcoMRC) attempts to mitigate and prevent risks to volunteers. Every attempt will be made to reduce risks to volunteers through training, education, and use of universal precautions. In addition, volunteers will only be matched to positions for which they have the skills and qualifications to fulfill safely. Volunteers Protected from Legal Liability: Under the Volunteer Protection Act of 1997, people who volunteer for non-profit organizations or governmental entities cannot be held liable for any harm (except for a harm caused by operation or a motor vehicle or a harm caused by criminal conduct or gross or reckless misconduct) that they may cause while engaged in volunteer activity. WCCHD qualifies under federal law, so if you volunteer, you can do so secure in the knowledge that you are not exposing yourself to additional legal liability. Credentialed and/or licensed medical volunteers are required to have malpractice insurance coverage before serving in a medical capacity.