Volunteer Application: Special Events

    Contact Information


    Name


    Street Address


    City, State, Zip Code


    Cell Phone


    Other Phone (circle: home, work)


    E-Mail Address


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    Employer or School (Current & Previous): Please attach a resume


    Name of Employer/School



    Position



    Contact Name



    Phone Number


    Availability


    Please check all that are applicable. I am available:






    Professional/School References


    Name



    Relationship



    Phone



    Email


    Special Skills or Qualifications

    Summarize special skills & qualifications you have acquired from employment, previous volunteer work, or other activities.

    Previous Volunteer Experience

    Summarize any previous volunteer experience.

    RELEASE OF LIABILITY

    I hereby fully and forever waive, release and relinquish and all claims, demands and actions whatsoever that I
    may have or may accrue to me against the Joe Torre Safe At Home Foundation, officers, agents, volunteers and
    employees arising out of this activity and/or any volunteer activity associated with or connected with this
    activity. Furthermore, I agree to indemnify and hold harmless and defend Joe Torre Safe At Home Foundation,
    from any and all claims and actions resulting from injuries, damages and losses sustained by me arising out of,
    connected with or in any way associated with this volunteer position. I have read this agreement and fully
    understand its content and sign it of my own free will. I further certify that I am (18) years of age or the
    parent/legal guardian of a minor participant.

    STATEMENT OF CONFIDENTIALITY

    As condition of being involved with persons seeking assistance from Joe Torre Safe At Home Foundation, I
    agree to keep confidential any information shared with me. I understand that no information concerning clients
    shall be released to other agencies or persons without signed, written consent of those involved. I recognize
    that the unauthorized release of confidential information may make me subject to civil action. I further
    understand that violation of this agreement is grounds for termination of my service.

    AUDIO/PHOTO/VIDEO MEDIA RELEASE FORM

    I grant permission to the Joe Torre Safe At Home Foundation and its agents or employees to use photographs
    and/or video and audio taken of me. These images may be used in educational and documentary materials such
    as Public Service Announcements, Grant Applications, Video Documentaries and both printed and online
    newsletters. Furthermore, I authorize the use of my image, likeness, and voice for all program promotion,
    materials, and any other purposes in connection with the program deemed appropriate and necessary by the
    Joe Torre Safe At Home Foundation. I hereby agree to release, defend, and hold harmless the Joe Torre Safe At
    Home Foundation and its agents or employees, including any firm publishing and/or distributing the finished
    product in whole or in part, whether on paper, via electronic media, or on Web sites, from any claim, damages,
    or liability arising from or related to the use of the photographs/video, including but not limited to any misuse,
    distortion, blurring, alteration, optical illusion, or use in composite form, either intentionally or otherwise, that
    may occur or be produced in taking, processing, reduction, or production of the finished product, its publication,
    or distribution. I waive any right that I may have to inspect or approve the finished product or products and the
    advertising copy or other matter that may be used in connection therewith or the use to which it may be
    applied.


    Signature (Parent/Guardian’s Signature, if under 18)


    Printed Name


    Date