Youth Volunteer Agreement and Release - Ravenswood Community Services

Youth Volunteer Information

Name*

First Last

Parent or Guardian Information

Name*

First Last

Phone*

Email*

Add an additional emergency contact:

Yes
No

Emergency Contact Name

First Last

Emergency Contact Phone

Volunteer Waiver

Please read before signing, as this constitutes the agreement as a volunteer and the understanding of your working relationship as a volunteer at Ravenswood Community Services (RCS), including All Saints’ Episcopal Church (ASEC).

Volunteer Waiver and Release*

I hereby acknowledge and state the following:

I have chosen to volunteer to feed hungry people and make a difference in the neighborhoods of Uptown, Ravenswood and Albany Park.

I understand that this work entails a risk of physical injury and involves physical labor, heavy lifting, and other strenuous activity. I am volunteering at my own risk. I assume all risk and responsibility for any damage or injury to my property or any personal injury, which I may sustain while volunteering, and related medical costs and expenses.

I understand that RCS and ASEC are not responsible or liable for my personal effects and property and that they will not provide security for any items. I will hold them harmless in the event of theft or for loss resulting from any source or cause. I further understand that I am to abide by whatever rules and regulations may be in effect during my service.

By my signature, for myself, my estate, and my heirs, I hereby release and discharge, and agree to defend, indemnify, and forever hold harmless RCS and ASEC and its officers, directors, agents, volunteers, servants, and employees, from any and all causes of action arising from or relating to my participation in this project, including any damages including, but not limited to claims for personal injury, sickness or loss of limb or life, even if said claims arise from injuries or illnesses caused by sole negligence or fault of those hereby released.

I grant full permission for organizers to use photographs and/or video of me and/or quotations from me and/or my name, without compensation, in accounts and promotions of this event and/or RCS and ASEC in perpetuity and in all forms of media now and forever known.

I may choose to participate in additional activities on multiple or later dates, and this Volunteer Agreement and Release will apply to any RCS activities in which I participate in the future. I hereby certify that I am under 18 years old and my parent’s or guardian’s signature below gives me permission to volunteer with RCS.

I understand and agree to this waiver and release.

Youth Volunteer Name*

Please enter your name as the primary signatory (Youth Volunteer) and to accept the waiver and release terms.

First Last

Parent or Guardian Name*

Please enter your name as an adult witness and to accept the waiver and release terms.

First Last

Confidentiality

Ravenswood Community Services is committed to protecting the confidences and confidentiality of those we serve. In order for those we meet to feel safe and willing to form ongoing relationships, they must feel they can trust all associated with RCS.

Confidentiality Agreement

We expect all staff, volunteers, and guests to maintain the confidentiality of our neighbors. This means:

1) You may share the content of your encounters with RCS staff present at our Tuesday night community kitchen and food pantry. You may want to share some of your experiences with friends, family, and/or co-workers. Please do this in a way such that the person about whom you are speaking cannot be identified.

2) NEVER share information about one neighbor with another neighbor.

3) When you are in other settings, do not acknowledge neighbors that you have met through your service at the community kitchen or food pantry, unless they acknowledge you first.

4) NEVER disclose the names of our neighbors to anyone until cleared by a staff member of RCS.

I understand the need for confidentiality and will not discuss, photograph, or otherwise disclose identifying information about the neighbors seeking help from RCS/ASEC without prior permission from RCS, including any reference to names, addresses, or other identifying information. I accept full responsibility, legal and otherwise, for failing to follow this agreement.

Youth Volunteer Name*

Please enter your name as the primary signatory (Youth Volunteer) and to accept the waiver and release terms.

First Last

Parent or Guardian Name*

Please enter your name as an adult witness and to accept the terms of this confidentiality agreement.

First Last