Please complete this application form if you are interested in becoming a Volunteers In Service to the Elderly volunteer. Once you complete the form, click the Continue button at the bottom.


Personal Information


General Information


Relevant Work/Volunteer Experience

List any relevant skills. Answer the question: I am the type of person that enjoys?



Communication 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.



Assignment Preference

Please place a check mark next to the volunteer opportunities that are of interest to you. Click on the volunteer assignment for a more detailed job description and contact information.



Other Volunteer Opportunities that Interest You

Please provide us with any other ways you would like to help.



Availability

Please indicate the days and times you are usually available to volunteer.



Volunteer area preference

Please indicate the area(s) you prefer to volunteer: South Lakeland, Central Lakeland, North Lakeland, Bartow, Mulberry, Ft. Meade.




Emergency Contact


Database Sign-in

Volunteers will be able to update their contact information, check volunteer schedule, and receive important volunteer updates. Please create a password for your volunteer sign-in with VISTE.



Is there anything else you'd like to share?


Personal Reference


Volunteer Agreement

Please read the following and indicate your agreement below.


I understand and agree that submitting this application form does not automatically register me as a VISTE volunteer, and that there may be certain qualifications I must meet, including the acceptance of established volunteer policies and procedures before I may begin volunteering.


By submitting this form, I attest that the information I have provided on the form is true and accurate.


This release and waiver of Liability (the “Release”) executed by the “Volunteer” in factor of VOLUNTEERS IN SERVICE TO THE ELDERLY, a non-profit organization, its directors, boards, employees, agents, representatives, and their respective successors and assigns, heirs, executors, and administrators (collectively “VOLUNTEERS IN SERVICE TO THE ELDERLY”).

The volunteer desires to volunteer for VOLUNTEERS IN SERVICE TO THE ELDERLY and engage in the activities related to being a volunteer. The volunteer understands that the activities may include but are not limited to providing transportation (using their own vehicle), cooking, carrying and lifting items, participating in special events and fundraisers, and engaging in other activities relevant to Volunteers in Service to the Elderly.

The volunteer hereby freely, voluntarily, and without duress executes this Release under the following terms:

Release and Waiver: Volunteer does hereby release and forever discharge and hold harmless VOLUNTEERS IN SERVICE TO THE ELDERLY and its successors and assigns from any and all liability, claims, and demands of whatever kind or nature, either in law or in equity, which arise or may hereafter arise from a Volunteer’s Activities with VOLUNTEERS IN SERVICE TO THE ELDERLY.

Volunteer understands that this Release discharges VOLUNTEERS IN SERVICE TO THE ELDERLY from any liability or claim that the Volunteer may have against VOLUNTEERS IN SERVICE TO THE ELDERLY with respect to any bodily injury, personal injury, illness, death, or property damage that may result from the volunteer’s activities with VOLUNTEERS IN SERVICE TO THE ELDERLY unless caused by the gross negligence of Volunteers in Service to the Elderly or its board, director, employees or otherwise. Volunteer also understands that VOLUNTEERS IN SERVICE TO THE ELDERLY does not assume any responsibility for or obligation to provide financial assistance or other assistance, including but not limited to medical, health, or disability insurance in the event of an injury or illness.

Medical Treatment: Volunteer does hereby release and forever discharge VOLUNTEERS IN SERVICE TO THE ELDERLY from any claim whatsoever which arises or may hereafter arise on account of any first aid, treatment, or service rendered in connection with the Volunteer’s Activities with VOLUNTEERS IN SERVICE TO THE ELDERLY.

Assumption of Risk: The Volunteer understands that the Activities include work that may be hazardous to the Volunteer, including, but not limited to transportation.

Volunteer herby expressly and specifically assumes the risk of injury or harm in the activities and release VOLUNTEERS IN SERVICE TO THE ELDERLY from all liability for injury, illness, death, or property damage resulting from the activities.

Insurance: The Volunteer understands that VOLUNTEERS IN THE SERVICE TO THE ELDERLY does not carry or maintain health, medical, or disability insurance for any volunteer.

Photographic Release: Volunteer does hereby grant and convey unto VOLUNTEERS IN SERVICE TO THE ELDERLY all rights, interest, in any and all photographic images and video or audio recordings made by VOLUNTEERS IN SERVICE TO THE ELDERLY during the Volunteer’s Activities with VOLUNTEERS IN SERVICE TO THE ELDERLY including, but not limited to, any royalties, proceeds, or other benefits derived from such photographs or recordings.

Other: Volunteer expressly agrees that this Release is intended to be as broad and inclusive as permitted by the laws of the State of Florida and that this Release shall be governed by and interpreted by the laws of the State of Florida. Volunteer agrees that in the event that any clause or provision of this Release shall be held to be invalid by any court of competent jurisdiction, the invalidity of such clause, or provision shall not otherwise affect the remaining provisions of this Release which shall continue to be enforceable.