I acknowledge and consent to the following terms and conditions:
1. Nature of Volunteer Work: I understand that as a volunteer, I may be involved in various tasks, which may include but are not limited to assisting therapists, interacting with children and their families, organizing materials, participating in administrative tasks and maintaining a clean and safe environment.
2. Non-Disclosure: I agree that at all times while volunteering at Premier Pediatric Therapy Source, Inc., and following the end of the volunteer opportunity, to maintain and not to disclose to any third party, any non-public, confidential or proprietary information relating to the business or financial practices, operations, contracts, instruction materials, education or exercise programs, marketing plans or materials, pricing, and/or any other confidential information or trade secrets of Premier Pediatric Therapy Source, Inc., including the terms of consent, whether or not labeled as “Confidential” and regardless of the method of transmission or the media in which the same is stored or recorded (“Confidential Information”).
3. Code of Conduct: I will conduct myself in a professional and respectful manner at all times while volunteering for Premier Pediatric Therapy Source, inc. I will follow the Practice’s policies and procedures, treat all individuals with respect and maintain a positive and supportive environment for children, families and staff.
4. Safety and Health: I understand that I must prioritize safety and adhere to all safety protocols and guideline provided by Premier Pediatric Therapy Source, Inc. I will promptly report any hazards, accidents or injuries to the appropriate staff members.
5. Liability Release: I release and hold harmless Premier Pediatric Therapy Source, Inc., its employees, contractors and agents from any liability for any injuries, damages or losses that may occur during my volunteer work.
6. Medical Information: I confirm that I am physically and mentally capable of performing the volunteer duties assigned to me. I will promptly notify the Practice of any medical conditions, disabilities or allergies that may affect my ability to perform my duties safely.
7. Background Checks: I understand that Premier Pediatric Therapy Source will require a background check as part of the volunteer screening process. I understand I have the right to withhold my consent to have a background check conducted however, in doing so I understand my application will not be processed. By signing this consent, I authorize Premier Pediatric Therapy Source to conduct a background check to ensure the safety and well-being of its clients and staff.
8. Photo and Video Release: I grant Premier Pediatric Therapy Source, Inc. permission to use any photographs or videos taken of me during my volunteer activities for promotional or educational purposes. This may include but is not limited to printed material, the Practice website, social media, email marketing and/or other advertising.
9. Duration of Volunteer Service: This consent form is valid for the duration of my volunteer service at Premier Pediatric Therapy Source. Either party may terminate the volunteer relationship at any time with prior notice.
By signing below, I acknowledge that I have thoroughly read and understand this consent in its entirety and agree to abide by the terms and conditions outlined herein.