Volunteer Application Form

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

E-mail*

example@example.com

Date of Birth (17 years old or younger will require parent or guardian signature)*

Date

Check one:*

MaleFemalePrefer Not to Answer

Why are you interested in volunteering with Fight 4 Cure Inc?*

Interest (Mark all that apply)*

Have you volunteered for any other 501(c)(3) nonprofits?*

YesNo

If you answered yes to the above volunteer question, please list the organizations. Also, list the name, email or phone number of a reference at each organization.

Do you have any convictions or please that you were convicted, plead of guilty or no contest to in the last 5 years?*

YesNo

Do you have any pending charges you were arrested for and are on bail pending trial?*

YesNo

If you answered yes to either of the above criminal questions, please provide an explanation.

Please upload a copy of your resume.

How did you hear about this volunteer program?*

VOLUNTEER GENERAL INFORMATION AND POLICIES LIABILITY RELEASE FORM

As a volunteer, you represent Fight 4 Cure Inc to the public. You accept responsiblity for this status and will conduct yourself in a professional manner. You are expected to be clean and sober when participating as a Fight 4 Cure Inc volunteer. You must maintain the confidentiality of all volunteers, clients, guests, and donors about whom you have personal identifying information. You must not particpate in and will report any and all instances of any sort of harrassment, exploitation, and/or intimidation. You must maintain an atmosphere of physical and emotional safety for everyone associated with Fight 4 Cure Inc including but not limited to (verbal or physical) exploitation or intimidation of any nature from volunteers, program participants, guests, or donors. Please maintain a friendly but respectful and professional interaction with our guests, clients, and donors. Do not give out personal contact information, including email address or phone numbers. If a guest, clients, or donor requests to contact you personally, please report it to Fight 4 Cure Inc President/Chair.

GENERAL CODE OF CONDUCT RULES

Fight 4 Cure Inc is a 501(c)(3) tax-exempt nonprofit organization with the mission of "helping one individual at a time....fostering hope for individuals affected by cancer: through providing financial assistance to individuals affected by cancer as well as help in the fight against cancer through cancer research and awareness. As a volunteer, your activities may included bu not limited to (a) physical activity with heavy tools and material, (b) contact with individuals affected by cancer, (c) travel to and from various locations, and (d) potential risk of injury. You must be willing to provide volunteer services with the knowledge of potential hazards involved and agree to accept any and all risks of injury without any recourse to or against Fight 4 Cure Inc.

I agree and release Fight 4 Cure Inc as follows: I have read, understand, and will observe Fight 4 Cure Inc Volunteer General Information and Policies, which may be updated from time to time. I understand that I am voluntarily participating in this service with the knowledge of potential hazards involved and accepting and assuming such risks however caused or alleged to be caused. The undersigned hereby agree(s) to accept and assume any and all risks of injury without any recourse to or against Fight 4 Cure Inc, except for injuries caused by Fight 4 Cure Inc gross negligence, fraud, willful misconduct or violation of law. In consideration of being permitted to participate in this service, the undersigned hereby waives, releases, discharges, indemnifies and holds harmless Fight 4 Cure Inc, and its directors, officers, partners, sponsors, donors, representatives, guests and affiliates from all claims for damages for personal injury or property damage that I, next of kin, legal representatives, or spouse now have or may hereafter have arising out of, based upon or relating to my participation as a volunteer and caused by negiligence (passive or active), strict liability or otherwise (except for such injury, wrongful death, or property damage caused by Fight 4 Cure Inc) gross negiligence, fraud, willful misconduct or violation of law).

I have carefully read this agreement, and the Volunteer General Information and Policies referenced herein, and fully understand their contents. I am aware that this is a release of liability. I have read the above waiver, have been fully and completely advised of the potential danger incidental to participating in the service, am fully aware of the legal consequences of signing this release, and I sign it of my own free will.

I also irrevocably grant to Fight 4 Cure Inc, its assigns and successors, my consent and full right to use my name, photo, likeness and written feedback in any and all media, publications, advertising and publicity. I grant permission to be filmed or taped by Fight 4 Cure Inc or the news media.

Volunteer Signature*

PARENT/LEGAL GUARDIAN

*For volunteers under 18, a parent or legal guardian's signature is required below. This certify that I, as a parent/legal guardian with legal responsiblity of the volunteer whose name appears above, do consent and agree to his/her release as provided above, and for myself, my assignees, next of kin, spouse, legal representatives, release Fight 4 Cure Inc from any and all claims that any of us now have or may hereafter having arising out of, based upon or relating to my minor child's participation as a volunteer and caused by negiligence (passive or active), strict liability or otherwise, (except for injury, wrongful death or property damage caused by Fight 4 Cure Inc gross negilgence, fraud, willful misconduct or violation of law).

I also irrevocably grant to Fight 4 Cure Inc, its assigns and successors, my consent and full right to use my name, photo, likeness and written feedback in any and all media, publications, advertising and publicity. I grant permission to be filmed or taped by Fight 4 Cure Inc or the news media.

Parent/Legal Guardian Signature

Date*

Date

Volunteer Application Form

Review and Sign Volunteer Release and Liability Form