Volunteer form

---

Volunteer form Please complete and return to: Feeding Greater Elgin 1553 Commerce Dr., Elgin

Contact information (please print) Name Address Home phone Work / cell phone Email address Emergency contact (name, phone & relationship)

General information Are you under 18? If yes, age and date of birth _________________________________________________ Minimum age to volunteer is 12, minimum ratio 3 minors to 1 adult. How did you hear about our organization?_____________________________________________________ Do you speak another language? ____________________________________________________________ Are you volunteering as part of a group?  No  Yes Name of group:__________________________ Are you volunteering for community service hours?  No  Yes Name of school or service organization ________________________________________________ If court ordered, please contact us for an appointment Volunteer opportunities (select your areas of interest)

Join a food distribution team (select preferred time and duty) Preferred time:

Mondays 5:30-8:30pm  Tuesday 8:30-11:30am Thursday 5:30-8:30pm  Saturday 8:30-11:30am

Wednesday 10:30am-1:30pm

Preferred duty:  Visitor registration – register clients for food distribution (computer experience necessary)  Distribution – assist clients with food selections and getting to the car  Warehouse stocking – sort donations and stock shelves (lifting may be required)

Volunteer during flexible times (select a preferred time and duty)     

Office tasks – data entry, correspondence, errands and reception (computer skills may be required) Food rescue – pick up food from local business partners (drivers license required) Warehouse – receive food, sort donations and stock shelves (lifting may be required) General maintenance – general facility maintenance and cleaning Special events

Preferred day of the week / hours ___________________________________________________________ Do you have any special skills you would like to share?___________________________________________ www.FeedingGreaterElgin.org

1553 Commerce Drive, Elgin IL 60123

847-931-9330

Volunteer release and waiver of liability agreement Feeding Greater Elgin, Inc., (hereinafter referred to as FGE), is committed to providing a safe atmosphere for the needs of the community. Therefore, FGE requires all volunteers to read and sign the following Release and Waiver of Liability Agreement: I,___________________________________(Volunteer) certify that I am in good health and I do not suffer from any disability or condition that could affect my duties as a volunteer at FGE or would in any manner endanger or put at risk any staff member of FGE. I further understand that the staff of FGE relies on the information provided by me in this form in order to provide the safest possible environment for the community. Therefore, I accept full responsibility and financial liability for any harm or damage whatsoever caused by me. 1.

2.

3.

4.

Hold Harmless. I agree to the fullest extent allowed by law, to protect, indemnify, and hold FGE, its agents, representatives, employees, volunteers, successors, and assigns, harmless from all claims or liability of every type (including court costs and legal fees) for any injury, death, or damage arising out of or relating to my services as a volunteer of FGE, whether or not caused or alleged to be caused in whole or in part by the negligence of FGE, its agents, representatives, employees, volunteers, successors, and assigns. I further agree that I will indemnify and hold harmless all of the above individuals or entities from any loss, liability, damage, or costs which may be incurred as a result of any claim that may be made. Release of Liability. I agree and hereby acknowledge that I am aware of the risks associated with volunteering with FGE. I agree to wear close-toed, non-slip shoes when I am volunteering. I hereby assume, accept, and acknowledge all responsibility for any dangers, accidents, risks, and hazards associated with said volunteer services provided by me to FGE and its successors and assigns, and I hereby agree to indemnify and hold FGE, its agents, representatives, employees, volunteers, successors, and assigns harmless from any injuries, claims, demands, causes of action, and damages, including attorney’s fees, resulting from any accident, incident , or occurrence arising out of or relating to my volunteer services provided to FGE and its successors and assigns, whether or not caused or alleged to be caused in whole or in part by the negligence of FGE, its agents, representatives, employees, volunteers, successors, and assigns. I agree that if, as part of my volunteer efforts, I am required operate a motor vehicle on behalf of FGE, I must have and do have a valid Illinois driver’s license that has not been suspended, revoked or is otherwise invalid. I further agree that I am not aware of anything that will impair my ability to operate a motor vehicle. I further agree to obey all traffic laws of the State of Illinois and agree that I will not use said motor vehicle for any purposes other than that for which I volunteered for on behalf of FGE. I agree to provide FGE with a copy of my valid driver’s license prior to operating a motor vehicle on behalf of FGE. I hereby give FGE permission to copyright and/or use, reuse and /or publish and/or republish pictures or images of me for the purpose of illustration, advertising, and promoting the agency through any medium. I hereby acknowledge that I have been given a reasonable opportunity to read the foregoing waiver, release of claims and photo release, and that I have read it and understand its provisions.

I HAVE READ THIS RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE, OR GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW. ________________________________________________ Printed name of Volunteer ________________________________________________ Signature of Volunteer

____________________________ Date

_______________________________________________ Signature of Parent/Guardian (if volunteer is under 18)

____________________________ Date

www.FeedingGreaterElgin.org

1553 Commerce Drive, Elgin IL 60123

847-931-9330