New Volunteer Registration
Name
*
First Name
Last Name
Will children accompany you?
*
Please Select
Yes
No
Names and ages of minor children (if applicable):
First child
*
First Name
Age
Second child
First Name
Age
Third child
First Name
Age
Fourth child
First Name
Age
Fifth child
First Name
Age
Email
*
example@example.com
Phone Number
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Church Affiliation:
How did you hear about Mercy House Global?
*
Please watch the 15 minute orientation video below
Have you completed the orientation video?
*
Yes
No
Emergency Contact
Name:
*
Phone number:
*
Relationship:
*
Please Select
Spouse
Parent
Friend
Employeer
Other
Acknowledgment
By my signature below I acknowledge that I have received a copy of the Mercy House Global Volunteer Policies and Procedures and that I have read and understood its contents. I understand that from time to time there may be revisions to the Volunteer Policies and Procedures and such revisions will be communicated to volunteers. I acknowledge that this policy is neither a contract of employment or volunteering and that I, and my accompanying minor children if applicable, will receive no compensation for my/our service. I further acknowledge that either Mercy House Global or I can terminate the volunteer relationship at any time for any reason or no reason. I further agree that Mercy House Global and its representatives may take photographs, videos, and other images of me (and/or my accompanying minor children), and I consent to Mercy House Global’s use of the photographs, videos, and other images taken or produced.I understand that Mercy House Global may use those items in fundraising, for marketing and promotional purposes, and in electronic media for an unlimited time period, and neither I, nor my accompanying minor children if applicable, will be entitled to receive any compensation, payment, royalty or other remuneration from Mercy House Global.
Name
*
First Name
Last Name
Signature
*
Date Signed
*
-
Month
-
Day
Year
Date
Waiver of Liability
I understand and acknowledge all of the risks and dangers associated with my participation, and my accompanying minor children’s participation if applicable, in activities and events organized or sponsored by Mercy House Global, including injuries or illness and damage or loss to property. I agree on behalf of myself (and my representatives, heirs, executors, administrators, successors, and assigns)and my accompanying minor children (and his or her representatives, heirs, executors, administrators, successors, and assigns) if applicable, to fully and forever, waive, release, discharge and to fully and forever hold harmless and indemnify Mercy House Global (and its officers, members, employees, agents, affiliates, successors, assigns, insurers and attorneys) from any and all liability, claims, damage, demands, losses, injuries, actions or causes of action of any nature whatsoever, known or unknown, foreseeable or unforeseeable, for any and all personal injury and/or property damages sustained by me or my accompanying minor children as a result of providing volunteer services. I acknowledge that this release and discharge of liability applies even though liability, claims, damage, losses, injuries, actions and causes of action may arise out of, or result from, negligence or carelessness, or any other fault, on the part of Mercy House Global.
Name
*
First Name
Last Name
Signature
*
Date Signed
*
-
Month
-
Day
Year
Date
We do not allow court-mandated Community Service.
Anyone under 18 must be accompanied by an adult.
Submit
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