Form

All the information on this application is accurate to the best of my knowledge. I understand that volunteering with Summerhouse Houston is not in any way an employment agreement, and that I will not receive payment for my time. I understand that if I am over 18, a criminal background check will be conducted prior to my volunteer assignment.

I understand that I must provide my own medical/accident insurance. I understand that Summerhouse Houston provides no such coverage.

Authorization is hereby given to the staff of Summerhouse Houston to obtain medical treatment for me in the event of an emergency.

The success of direct member services as conducted by Summerhouse Houston is often dependent upon access to and review of past and current demographic, personal, and medical information. The trust between volunteers and members must be respected during direct communications and by adhering to professional codes of confidentiality. Volunteers working within a direct service program of Summerhouse Houston may have access to such information are required to abide by this policy on confidentiality. I have read and understand the above statement and agree to abide by Summerhouse Houston’s policy on confidentiality.

Any person who believes that an individual is being abused, neglected, or exploited is required by law to report this information to the Texas Department of Protective and Regulatory Services Abuse Hotline, 1-800-252-5400, within 48 hours of the time one suspects the person has been or may be abused or neglected. Abuse and neglect include, but are not limited to, physical, emotional, or mental injury or failure to prevent such injury. If a volunteer witnesses what s/he considers to be abuse or neglect, s/he is required to inform the Program Director as soon as possible. The Program Director will then inform the Executive Director. An incident report must be turned in within 48 hours of any suspected abuse or neglect. If a volunteer is suspected/accused of abuse or neglect, s/he will be suspended from their position pending an investigation by the Program Director and until such final determination is made. Failure to comply with this policy is automatic grounds for dismissal.

I give my consent for the release of any publicity pictures or videos by Summerhouse Houston that would assist in promoting and providing various services for persons with intellectual and other developmental disabilities.

Summerhouse Houston volunteers must meet the following requirements: 18 years or older Ability to pass a background check If working directly with members - commitment to at least 1 activity a week per semester (fall, spring, and/or summer) Must attend orientation and training Personal reliable transportation preferred; at minimum, volunteers need to be able to get to Summerhouse Houston or the location of the activity independently. If the volunteer does not have own transportation and meets at Summerhouse Houston, then he/she would need to participate in activities in which there is available space in Summerhouse Houston vans/cars. Maintain regular communication via text or email with Summerhouse Houston staff Compliance with Summerhouse Houston policies and rules Creative, outgoing, respectful, flexible, and willing to work with young adults with varying abilities I have read and understood the above requirements and certify that I meet each one. I acknowledge that if at any time I am no longer able to meet any requirement or cannot attend a certain activity, I will notify Summerhouse Houston staff immediately. I understand that my participation with Summerhouse Houston is voluntary, and I will not receive monetary compensation for my time volunteered. If I no longer comply with Summerhouse Houston policies and rules, I understand that I may be asked to no longer volunteer with Summerhouse Houston.

To complete this process please download the following Background Check Authorization form, fill it out, and upload it to this form.