Volunteer Application

The questions within this form allow us to create a meaningful conversation with you regarding serving at Village of Hope, as well as assisting us to ensure the opportunities available to you are fully discussed and understood.

First name

Last name

Phone

Street Address

City

Region/State/Province

Postal / Zip code

Birthday

Occupation:

Emergency Contact Name & Phone Number:

Tell us about any specific talents, gifts, abilities, hobbies that might be a benefit to Village of Hope.

Why are you interested in volunteering with Village of Hope?

What church do you attend (if any)?

Have you or are you currently serving with any other organization? If yes, in what capacity are you serving there?

What is your avalability (number of hours and days of availability)?

Volunteer Confidentiality Agreement

I acknowledge that during the course of performing my assigned duties at Village of Hope, I may have access to or use confidential resident, staff, volunteer, or donor information. I agree to handle such information in a confidential manner at all times during and after my volunteering ends. I understand the following:

Confidential information is any information I learned because of my volunteering with Village of Hope that is not generally known to people outside of the organization. Information about residents, donors, donations, volunteers, and financial information relating to the organization; are among the information that must be strictly confidential.

I understand that I must never provide identifying information about residents when having personal discussions, doing presentations on behalf of Village of Hope, or in other settings where the recipients of the information do not have a legitimate need to know the information. This includes safeguarding first names, last names, ages, race, personal histories, where they have lived, and any other information that may allow someone to identify them.

I understand that I have a legal obligation to keep confidential our residents 1) past, present, or future physical and mental health or conditions; and, 2) the services that we are providing to them. Only persons with a clear need to know should receive such information. All employees must keep PHI strictly confidential, including being careful to avoid being overheard by other residents or volunteers when discussing a resident’s need.

I also understand that volunteers who improperly use or disclose confidential Village of Hope or resident information, including PHI, will be subject to corrective action, which could include termination of employment, or legal action, even if they do not benefit from the disclosed information. This confidentiality obligation continues even after volunteers no longer volunteer for Village of Hope.

When my volunteering assignment ends, I agree to return to the director all Village of Hope confidential materials that I may possess. I further agree to not use or share with others any confidential information for any reason. I will not give professional direction to residents after my volunteering ends.

Assumption of Risk and Release from Liability

Please read carefully. This is a legal document that affects your legal rights. If you have any questions about this document, please contact an attorney.

Purpose: I requested to volunteer at Village of Hope to participate without pay as a volunteer.
Acceptance of Risk: I am aware that some volunteer assignments may have hazardous activity and entail risks. I understand that any volunteer assignment that I agree to perform, even those that are not extremely physical in nature, has its risks. I am voluntarily participating in the activities and I'm accepting the risk. Hazardous activities may include, but are not limited to, building, loading and unloading materials, painting, finishing, framing, carrying such materials to and from building sites, moving furniture, and other related activities. I understand the danger involved in such activities and participate with the acknowledgement that medical facilities are not available in the event I become ill or injured. Thus, I agree to accept any and all risks of injury, illness, or death.
Release: In exchange for being permitted by Village of Hope to participate in volunteer activities and use of their tools and facilities, I agree that I, my heirs, personal representatives, and assigns, will not make a claim against Village of Hope, or its directors, officers, agents, employees, volunteers, suppliers, contractors, subcontractors, or attorneys (the “Released Parties”), or damages resulting from the negligent or intentional Acts or omissions of the Released Parties. I release the Released Parties from all actions, claims, or demands that I, my heirs, personal representatives, or assigns now have or may have in the future for injuries, damages, or death resulting from participating in any Village of Hope activities. I understand that my agreement to this release will remain in effect throughout the entire time that I perform volunteer work for Village of Hope, unless I later revoke it in writing to the Village of Hope Executive Director or I complete another release on a later date.
Indemnity: I agree to indemnify and hold harmless the Released Parties from any and all loss, liability, claims, damages, cost, and expenses (including attorneys fees) resulting from or relating to, in whole or in part, my participation as a volunteer in activities at Village of Hope.
Additional Release: I transfer to Village of Hope all right, title, and interest I may have in any and all photographic images, video or audio recordings, interviews, or other written, visual, or broadcast media made, originated or created by Village of Hope or its agents or employees during or in connection with Village of Hope volunteer program, including (but not limited to) any royalties, proceeds, or other benefits derived from such materials.
Comprehension and Appreciation: I have carefully read this Assumption of Risk and Release of Liability Agreement and fully understand its contents. I am aware that this is a legal contract between Village of Hope and me and that it affects my legal rights. I also understand that by releasing Village of Hope from liability, I am giving up certain rights that I would otherwise retain. I acknowledge that I have had the opportunity to review this document and seek legal advice if I have any questions.
Insurance: I understand that Village of Hope does not maintain health insurance for volunteers.
Intent of Agreement: I expressly agree that this agreement is intended to be as broad and inclusive as permitted by the laws of the State of Arizona and that this agreement shall be governed by the interpreted in accordance with the laws of the State of Arizona.
Arbitration: In the event of any claim or dispute relating to this agreement or any of the activities or other matters described in this agreement, I agree that such dispute shall be settled by binding arbitration in the City of Prescott, in accordance with the rules then prevailing of the American Arbitration Association, in lieu and instead of a jury trial.
Entire Agreement: This agreement embodies the entire agreement and understanding between Village of Hope and me. This agreement may not be changed, waived, discharged, or terminated unless agreed to in writing by Village of Hope and me.
Severability. I agree that in the event that any clause, sentence, or provision of this agreement shall be held to be invalid by any court of competent jurisdiction, the validity of that clause or provision shall not otherwise affect the remaining provisions of this agreement which shall continue to be enforceable. This agreement is binding upon me and my heirs, personal representatives, and assigns, and any other person making a claim on my behalf. In addition, if I am a married person, I agree that this agreement is made by me on my behalf and on behalf of the marital community of my spouse and me, and I agree that this agreement will be binding on that marital community.
Minors: Due to the potential hazards of some assignments, volunteers under the age of 18 years of age must be accompanied by an adult supervisor. Minors volunteering in non-hazardous areas must have this form and written authorization from a parent on file at Village of Hope prior to their volunteer event.

By typing your name below you are signing this application electronically and stating that the information provided in this application is true and accurate AND that you have read, understand, and agree to the Volunteer Confidentiality Agreement Assumption of Risk and Release from Liability.

Thanks for applying to volunteer with us! We'll get back to you soon.