Volunteer Terms and Agreements:
Please read each term and agreement carefully, when done initial name where indicate to do so:
Consent: I acknowledge that all the above information is accurate and that my decision to participate in the program is completely voluntary. I also agree that in the event that any information changes during the time of my participation at Capital District Latinos and/or Acacia Network, that I will inform the facility immediately. I, hereby release, waive, acquit and forever discharge the Capital District Latinos and Acacia Network, their representatives, successors, insurers, assigns or any other person or entity associated with any of the above organizations such as staff, directors or volunteers, from all liability, claims, demands, or causes of action for any and all loss, damage, injury or death and any claim of damages resulting from use of facilities owned or controlled by the above organizations, or participation in activities of said organizations either at or away from the facilities.
Confidentiality: Any confidential information requested is for our records and for the funding our organization receives. The answers you provide will be kept strictly confidential and will be subject to the Data Collection section below. Your cooperation in providing this information is both appreciated and necessary.
Photo, Still, or Video Images: I authorize the Capital District Latinos and Acacia Network to utilize still and video images of myself, statements, and voice in its promotional and/or educational materials, with or without my name. I understand that these still and video images, statements and audio recordings may be used in print, radio, television and on the internet or social media. I waive any rights I may have in such images, statements, and audio recordings, as well as the privilege of inspecting or approving them for determining their final disposition. I understand and agree that my participation may reveal services I am receiving from Capital District LATINOS and/or Acacia Network, Inc. and I authorize the release of this limited information in conjunction with my voluntary participation. I release Capital District Latinos and/or Acacia Network from all claims, demands, and liabilities for the use of this information by Capital District Latinos and/or Acacia Network, Inc., its agents and employees whatsoever in connection with the above.
Data Collection: I give my permission to the Capital District Latinos to collect information via online or written surveys, questionnaires, interviews, and focus groups for all the household members on this application. Any and all information received will be kept strictly confidential. Data gathered through these means will be summarized in the aggregate and will exclude all references to any individual responses. The aggregated results of these analyses may be shared with organization staff, funders, and other community stakeholders to evidence program effectiveness and/or organization impact.
Emergency Consent: I understand that Capital District Latinos assumes no responsibility for injuries or illnesses which I may sustain as a result of my physical condition or resulting from my participation in any activity or program. In the event of an emergency, Capital District Latinos has my permission to administer immediate first aid by qualified personnel to myself and to contact emergency authorities.