We are so grateful for your interest in volunteering at Tricounty Family Ministries. Your time is valuable, and it means so much that you are thinking about joining us in our fight against hunger, homelessness and generational poverty in our community.

Please complete this application form and click the submit button at the bottom.

Once your application has been received, we will be in touch with you.

Thanks again for your interest in Tricounty Family Ministries.

Volunteer Information

How did you hear about Tricounty Family Ministries?

First name:

Last name:

Street 1:

City:

State:

* Zip: *

Cell phone:

* OK to call me here

Email address:

Date of birth:

(year optional)

Age range:

Gender:

School:

Business/Group/Church:

Group Contact Person:

Contact's email and/or cell:

Number of volunteers in your group:

What interested you in volunteering for Tricounty Family Ministries?

Areas of Interest

You may optionally provide the following information. It is used only to help us get a better idea of the demographic make-up of our volunteers.

Skills/Profession:

skills/profession

Do you have any special skills like carpentry, plumbing...

Availability

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.

Mon

Tue

Wed

Fri

From:

To:

I would like to serve up to:

hours:

Do you have any physical limitations that would prevent you from volunteering or performing the task you would like to do?

Emergency Contact

First name:

Last name:

Cell phone:

Relationship:

Parental Release Form

I being the parent or legal guardian of the “Minor” hereby consent to and authorize the Minor to act as a volunteer for Tricounty Family Ministries. I acknowledge and agree that activities performed by the Minor as a volunteer will be performed strictly on a voluntary basis, without any pay, compensation, or benefits. I agree and understand that the Minor must comply with the rules and regulations established from time to time by Tricounty Family Ministries and that failure to do so may result in the Minor’s immediate removal as a volunteer.

I am aware of the nature of the activities to be performed by the Minor as a volunteer and recognize that in performing volunteer tasks, a risk of harm, injury, illness or disease exists. I agree that all volunteer activities are to be performed by the Minor at the Minor’s risk and I assume full responsibility therefore.

I understand that public relations are an important part of volunteering at Tricounty Family Ministries. I consent to and authorize Tricounty Family Ministries to use any photographs taken of the Minor for public relations.

On behalf of myself, the Minor, and our respective heirs and personal representative, I agree not to hold or attempt to hold Tricounty Family Ministries, their officers of employees responsible for any injury or damage sustained or incurred by the Minor arising out of or in any way connected with the Minor’s activities as a volunteer for Tricounty Family Ministries and hereby release and discharge the Organization, their officers and employees from any and all claims, demands, causes of action of any nature or cause, for any such injury or damage incurred or suffered by the Minor.

Please check the box below to accept the terms of the Parental Consent Form.

Parental Consent Form:

Release and Waiver

I hereby release and forever discharge and hold harmless Tricounty Family Ministries 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 Volunteer’s Activities with Tricounty Family Ministries. I understand that this Release discharges Tricounty Family Ministries from any liability of claim that I, the Volunteer, may have against Tricounty Family Ministries with respect to any bodily injury, personal injury, illness, death or property damage that may result from my activity as a Volunteer with Tricounty Family Ministries, whether caused by the negligence of Tricounty Family Ministries or its officers, directors, employees, r agents or otherwise.

I also understand that Tricounty Family Ministries 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 injury or illness.

I, the Volunteer, do hereby release and forever discharge Tricounty Family Ministries from any claim whatsoever which arises or may hereafter arise on account of any first aid, treatment, or service rendered in connection with my activities as a Volunteer with Tricounty Family Ministries.

It is the policy of Tricounty Family Ministries to ensure that the operations, activities, and affairs of the organization are kept confidential.

I recognize that Tricounty Family Ministries is engaged in business that collects and reports confidential information and that it is important for Tricounty Family Ministries to protect its confidential information. Therefore, because I wish to be a volunteer with Tricounty Family Ministries in a capacity where I will receive and/or contribute to confidential information, I agree to be bound by the following terms and conditions which are described below.

1. Definition of Confidential Information

In this agreement, “confidential information” includes client/volunteer/donor/financial information. This includes all confidential information entered into any computer system and/or any confidential information of a verbal nature.

2. Non-Disclosure of Confidential Information

I agree to retain all Confidential Information in the strictest confidence. I will not disclose any Confidential Information to any person other than for the purposes of Tricounty Family Ministries, and I will not use for my own purposes other than those of Tricounty Family Ministries. I further understand and acknowledge that my agreement to maintain the confidentiality of Tricounty Family Ministries and/or client information shall remain in full force during my volunteer assignment and at all times thereafter.

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

I Agree