MAP Volunteer Application Updated

Volunteer Readiness Checklist

Ensure you have the availability for a Volunteer Assignment at MAP
Complete and submit a Volunteer Application Packet including:
- Volunteer Application
- Volunteer Contact List
- Photo Consent Waiver
- MAP Indemnification and Waiver Agreement
Attend a Volunteer Orientation
Meet/train with your area supervisor and determing a schedule

Submitting this application is the first step towards becoming a volunteer at MAP. After submitting your application, it will be reviewed by MAP's Farmhouse and Activities Coordinator. Eligible candidates will be contacted by MAP to register for a Volunteer Orientation where you will learn more about MAP and our policies and procedures for volunteers.

Massachusetts Avenue Project (MAP) seeks to involve the community in meaningful volunteer work. Volunteer programs, projects, and assignments are designed to mutually benefit both MAP and its volunteers with the intention of enriching their lives and increasing positive outcomes for community members and stakeholders. MAP values the impactful service of its volunteers and strives to provide positive educational and experiential learning opportunities whenever possible.

Qualified applicants receive equal consideration. No question is asked for the purpose of excluding any applicant due to their race, ethnicity, national origin, religion, age, sex, sexual preference, disability, veteran status or any other characteristic protected under local, state or federal law.

Name*

Legal Name (if different)

Pronouns

Date of Birth*

Date

Address*

Street Address

Street Address Line 2

City, State & Zip Code

Home or Cell Phone*

E Mail Address*

example@example.com

Which Languages do you speak, read/write and understand?

I Speak*

I Read/Write*

I Understand*

Which Volunteer Assignment are you interested in? You must select at least one.

Farm Volunteer Group (Tuesday Mornings) Program runs June-September. Volunteers commit to weekly, short, regular shifts (2-4 hours) Farm Group shifts are between the hours of 8:00 am 12:00 pm.

Check to select this option

If you selected the Farm Group, indicate your availability here:

Mobile Markets Volunteer (Weekdays). Program runs June-October. Volunteers commit to weekly. short, regular shifts (3-5 hours). Volunteer shifts are between the hours of 9:00 am 7:00 pm.

Check to select this option

If you selected the market, please indicate your availability here.

If you have a skill you'd like to share with MAP please describe it and your availability here

Do you have any special requirements for a class, service learning program, internship, or other program? If so, please select from below

Volunteer RequirementService Learning ProjectInternshipOther Requirement

Do you have a required number of hours to fulfill? If so, how many hours?

I need to fulfill

Do you have specific dates you need to fulfill your service within?

I need to fulfill my service between

and

Are there any other details about your requirements that you can share with us? If so, please share here

Are you allergic to bees? If so, do you have an Epi Pen?

Do you have asthma? If so. do you use an inhaler?

Can you repeatedly lift 50 pounds?

Do you have any food allergies?

Do you need any accommodations from MAP in order to volunteer safely?

I understand that my volunteering may be terminated with or without cause or notice, at any time, at either my option or that of the company. / have provided truthful and complete responses to all inquiries in the application and authorize the company to investigate all statements contained in the application. / understand that the discovery of any folsification or omission constitutes a ground for immediate dismissal. If / volunteer, / will abide by the MAP's rules and regulations, which / understand are subject to change. / agree to give a minimum of 2 weeks notice if my availability to volunteer changes.

Name *

Signature*

Clear

Date*

Date

Questions regarding MAP's Volunteer Program can be directed to:

Sarah Klawinski, Development Director

development@mass-ave.org

716-882-5327 x2

For the safety of those volunteering at MAP, please provide 3 Emergency Contacts that are up to date. If you are a minor (under 18) please make your 1st Emergency Contact your parent or guardian.

Your Name

Signature*

Clear

Date*

Date

Emergency Contact Information #1

Name*

Relationship to Contact*

Address*

Street Address

Street Address Line 2

City, State & Zip Code

Phone #1*

Phone #2

Emergency Contact Information #2

Name*

Relationship to Contact*

Address*

Street Address

Street Address Line 2

City, State & Zip Code

Phone #1*

Phone #2

Emergency Contact Information #3

Name

Relationship to Contact

Address

Street Address

Street Address Line 2

City, State & Zip Code

Phone #1

Phone #2

Are you allergic to bees? If so, do you have an Epi Pen?*

Do you have asthma? If so, do you use an inhaler?*

Do you have any other physical limitations?*

Volunteers have the right to update their current information on their Volunteer Application, or Emergency Contact List via email request to the Development Director (developmentamass-ave.org)

Name*

Date of Birth*

Date

Address*

Street Address

Street Address Line 2

City, State & Zip Code

Cell Phone*

E-Mail Address*

Facebook (optional, if you would like to be tagged)

Instagram (optional, if you would like to be tagged)

Please share 3 4 sentences about yourself and your background, and 1 2 sentences about why you want to volunteer at MAP. We will be using these for Volunteer features on our E Newsletter, Website, and social media.

As a volunteer of Massachusetts Avenue Project (MAP), I give my consent to be photographed, videotaped or recorded by MAP, its employees, and any person acting under its authority or permission.

I hereby consent that photographs and/or videotapes of me may be taken or used by Massachusetts Avenue

Project for public and private documents, advertisements, publicity and web content consistent with the purpose and mission of MAP, including publication on MAP's website. I further agree that said materials shall become the property of MAP. I hereby release and discharge MAP and its representatives from any and all claims that may arise by reason of taking of said photographs and/or videotapes.

I understand that I have the right to revoke this decision at any time. If this is the case, I understand that I must provide a written request to the Development Director of MAP to rescind my consent.

Name *

Signature*

Clear

Date*

Date

Massachusetts Avenue Project (MAP) Indemnification and Waiver Agreement

THIS INDEMNIFICATION AND WAIVER AGREEMENT (this "Agreement") is made as of theday of 20 (the "Effective Date" by and between Massachusetts Avenue Project. a Buffalo, NY non-profit with a principal office at 387 Massachusetts Avenue. Buffalo, New York 14213 ("MAP"), and ("Volunteer"), a (please circle one) [corporation/ limited liability company/ community organization or individual] located at(Volunteer address)

WHEREAS, MAP owns and operates a building and farm at 387 Massachusetts Avenue, Buffalo, New York and additional land at 40-44 Winter Street (the "Properties") and as a condition to Volunteer's use and access to the Properties, MAP has requested that the volunteer execute this Agreement to place reasonable limitations on MAP's liability for on-site conditions.

The above named parties agree as follows:

1.To the fullest extent permitted by law, including the prohibitions of New York General Obligations Law

5-322.1, Invitee will indemnify. and hold harmless MAP. and each of their respective affiliates, directors, partners. shareholders, managers, members, representatives, agents, and employees (collectively the "MAP Indemnitees") from and against any and all claims, suits, liens, judgments, damages, losses and expenses, including reasonable legal fees and court costs and liability arising in whole or in part from any injury and/or death to an individual or damage to or loss of any property to the extent resulting from the acts, errors, omissions, breach, or default by the volunteer, or any license of the volunteer, in connection with Volunteer's use of an access to the Properties, excepting any claims, suits, liens, judgments. damages, losses and expenses solely caused by the gross negligence or intentional misconduct of a

2.To the extent allowable by law. the volunteer waives any claims it may have against any MAP Indemnitee as a result of the volunteer's use of and access to the Properties, and further releases all MAP Indemnitees from any and all liability for any such claims, except in the event a claim is due solely toany MAP Indemnitee's gross negligence or intentional misconduct.

3. IN NO EVENT SHALL MAP BE LIABLE FOR ANY INDIRECT. INCIDENTAL, SPECIAL, CONSEQUENTIAL, PUNITIVE, OR TORT DAMAGES OF ANY NATURE OR KIND, WHETHER BASED ON BREACH OF CONTRACT, TORT (INCLUDING NEGLIGENCE) OR ANY OTHER LEGAL THEORY IN CONNECTION WITH OR ARISING OUT OF THE USE OF AND ACCESS TO THE PROPERTIES HEREUNDER, EVEN IF MAP HAS

BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. IN NO EVENT SHALL MAP BE LIABLE TO THE VOLUNTEER UNDER THIS AGREEMENT WITH RESPECT TO DAMAGES ARISING UNDER ANY CLAIMS OR AGGREGATE OF CLAIMS IN ANY AMOUNT WHICH EXCEEDS THE AGGREGATE AMOUNT

OF ANY FEE(S) PAID UNDER THIS AGREEMENT.

4. If any part, term, or provision of this Agreement is held to be illegal or unenforceable the validity or the enforceability of the remainder of this Agreement shall not be affected. 5. This Agreement constitutes the entire understanding between the parties relating to the matters contained herein, and supersedes all prior representations, negotiations, or understandings between the parties. Except as otherwise expressly provided in this Agreement, this Agreement may be amended or waived if, and only if, such amendment or waiver is in writing and signed, in the case of an amendment, by the volunteer and MAP or, in the case of a waiver, by the party against whom the waiver is to be effective. The failure of either party to enforce its rights under this Agreement at any time for any period shall not be construed as a waiver of such rights.

6.This Agreement shall be governed by and construed in accordance with the laws of the State of New York, without reference to its choice of law rules. The parties irrevocably submit to the exclusive jurisdictionof the courts of the State of New York, County of Erie, for the purpose of any suit, action, or other proceeding arising out of this Agreement of the subject matter hereof, This Agreement may be executed in one or more counterparts, each of which shall be deemed an original and all of which shall constitute one and the same agreement, and shall become effective when one or more counterparts have been signed by each of the parties and delivered to the other party. it being understood that all parties need not sign the same counterpart.

IN WITNESS WHEREOF, the Parties hereto have executed this Agreement on the date set forth above.

Volunteer Signature*

Clear

Volunteer Name*

MAP Volunteer Application

Volunteer Application

Volunteer Contact List

Volunteer Photo Consent

Indemnification and Waiver Agreement