PA Support Group Childcare

Palo Alto Support Group Childcare Volunteer

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Name(Required)

First Last

Phone(Required)

Email(Required)

Your preferred form of communication:(Required)

Text

Both are fine

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Birthdate(Required)

Emergency Contact Name(Required)

First Last

Emergency Contact Relationship(Required)

Emergency Contact Phone Number(Required)

Do you currently attend a church?(Required)

Yes

Which church do you attend?(Required)

Personal and Professional References

References #1(Required)

First Last

References #1 Phone(Required)

References #1 Email(Required)

References #2 Name(Required)

First Last

References #2 Phone(Required)

References #2 Email(Required)

Spiritual Reference Name(Required)

First Last

Must be a pastor or ministry leader at your church

Spiritual Reference Phone(Required)

Spiritual Reference Email(Required)

Why are you interested in joining the childcare volunteer team?(Required)

What is your experience working with kids? What is your experience working with kids who are impacted by foster care and/or adoption?(Required)

Volunteer Agreement and Release of Liability

Volunteer Code of Conduct(Required)

I agree to the privacy policy.

I agree to work for Help One Child and Peninsula Bibile Church Palo Alto,(the “Nonprofits”) as a volunteer at “Help One Child’s Palo Alto Support Group” - herein described as the “Event”.

2. As a volunteer, I understand that I control the dates and times that I agree to do the work and that neither Nonprofit is responsible for scheduling my volunteer work. I also understand that I will not be compensated for any time spent volunteering, nor am I entitled to benefits, including employment insurance benefits upon the termination of this agreement or as a result of this service.

3. I am aware that participation as a volunteer may require periods devoted to outdoor games and will require the exercise of reasonable care to avoid injury. I am voluntarily participating in this Event with knowledge of these activities and agree to accept any and all risks of personal injury and property damage.

4. As consideration for volunteering for these Nonprofits I hereby agree that I, and my assignees, heirs, guardians, and legal representatives, will not make a claim against or sue the Nonprofits or their employees, agents 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 either Nonprofit as a result of my volunteering.

5. I HEREBY RELEASE AND DISCHARGE THE NONPROFITS AND THEIR OFFICERS, EMPLOYEES, AGENTS AND CONTRACTORS FROM ALL ACTIONS, CLAIMS, OR DEMANDS THAT I, MY HEIRS, GUARDIANS, AND LEGAL REPRESENTATIVES NOW HAVE, OR MAY HAVE IN THE FUTURE, FOR INJURY OR DAMAGE RESULTING FROM MY PARTICIPATION IN THE EVENT.

6. I UNDERSTAND THAT IF I AM INJURED IN THE COURSE OF THE EVENT, I AM NOT COVERED BY THE NONPROFITS’ WORKERS’ COMPENSATION PROGRAM. I authorize the Nonprofits 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 I will be responsible for medical costs incurred by such accident, illness or injury.

7. I understand that any equipment, crafts or other materials provided by the Nonprofits are and remain the property of the Nonprofits and I agree to return any remaining materials to the Nonprofits at the end of my volunteer service.

8. I, hereby, authorize the making of photographs, motion pictures, videotapes, recordings, or other memorializing of said event and his/her participation therein, and the publication or other use thereof. I, hereby, waive any right to compensation therefore or any right that I otherwise might have to limit or control such.

I have carefully read this agreement and fully understand its contents. I am aware that this is a release of liability and sign at my own free will.*

Core Statements, Vision, and Mission

CORE STATEMENTS: It is the hope of Help One Child that foster children will be introduced to the love and teachings of Jesus Christ through their stay in Christian foster homes. Help One Child recruits foster parents and a volunteer support network for them from Christian churches that adhere to orthodox Christian doctrine and orthodox Biblical interpretation. Protestant and Catholic churches are included in the network with a broad representation of ethnicities and expressions of worship. The Apostles’ Creed represents Help One Child’s doctrinal faith principles and is generally accepted by the churches in which we recruit. VISION: Our vision is to mobilize and involve Christians in the effort to provide loving, nurturing homes for the thousands of Bay Area foster and other at-risk children. We dream of the day when Christian churches become the number one recruiting resource for children in need of loving homes, temporary or permanent. MISSION: Help One Child is a 501(c) (3) nonprofit public benefit corporation dedicated to recruiting train and supporting those willing to provide home or volunteer services for at-risk children.

Applicant's Statement

The information contained in this application is correct to the best of my knowledge. In consideration of the receipt and evaluation of this application by Help One Child, I hereby release any individual, church, youth organization, charity, employer reference, or any other person or organization, including record custodians, both collectively and individually from any and all liability for damages go whatever kind or nature which may at any time result to me, my heirs, or gamily, on account of compliance or any attempts to comply, with this authorization. I waive any right that I may have to inspect any information provided about my by any person or organization identified by me in this application.

I further state that I have carefully read the foregoing release and know the contents thereof and I sign this release as my own free act.

Name(Required)

First Last

Signature(Required)

PA Support Group Childcare

Palo Alto Support Group Childcare Volunteer

Personal and Professional References

Volunteer Agreement and Release of Liability

Core Statements, Vision, and Mission

Applicant's Statement

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