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  • Before filling out these forms, please make sure to review our Volunteer Handbook at www.zelieshome.org/volunteer-handbook

  • Zelie’s Home Volunteer Information

    Human Dignity |​ Supportive and Collaborative Community​ | Commitment to Growth Safe Learning Environment​ | ​Resiliency and Creativity
  • As a volunteer:

    • I am aware of the core values of Zelie's Home and will incorporate them into discussions as needed or appropriate. 
    • I am aware that Zelie's Home does not extend worker’s compensation coverage to its volunteers.
    • I understand the confidentiality statement and agree not to misuse any personal information I may have access to during my duties as a volunteer as outlined in the Volunteer Handbook.
    • I agree to disclose any criminal charges and convictions (either pending or final).
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  • Emergency Contact Information

  • In-Home Volunteer Agreement & Release

  • The parties, Zelie's Home, and (Volunteer), enter into this Volunteer Agreement & Full Release effective this      day of    ,   wherein, in exchange for the opportunity to volunteer at Zelie's Home, Volunteer agreed to the following terms and conditions:

    1. Volunteer agrees that s/he is volunteering solely for personal, civil, charitable or humanitarian purposes without promise or expectation of compensation, benefits or future employment from Zelie's Home 
    2. Volunteer will perform services under the direction and control of the staff. 
    3. Volunteer will assist with the following assignments:  yard work, cooking, cleaning, house coverage, baby-sitting, data input, and other light chores as requested. 
    4. Volunteer acknowledges that s/he is not an employee of Zelie's Home and is not entitled to receive salary, benefits or other compensation.  Volunteer further acknowledges 100% of all funds raised by him/her while volunteering for Zelie's Home will go to Zelie's Home as a nonprofit organization.
    5. Volunteer understands that s/he does not qualify for worker’s compensation benefits, and is expected to carry personal medical insurance to cover medical expenses for any injury s/he may incur while performing services voluntarily for Zelie's Home  
    6. If Volunteer is not a citizen or permanent resident of the United States, Volunteer certifies that s/he has appropriate visa status that authorizes Volunteer to be present in the United States and allows Volunteer to participate in the volunteer experience.  
    7. The parties agree that this is the entire Agreement between them and that no Agreement, either oral or written, exists outside this Agreement regarding the volunteer services described in the Agreement.  
    8. I hereby grant full permission to Zelie's Home to use my name and likeness in all forms in any and all media including but not limited to publications, brochures, books, magazines, photo exhibits, video, and/or other media or commercial, informational, educational, advertising, or promotional materials without compensation. 
    9. Volunteer agrees that they will not use the name and likeness (photo, video, voice recording and/or any and all forms) of any client of Zelie's Home (moms, kids, babies) in any and all forms of media including but not limited to social media unless they have written consent from client.
    10. Volunteer agrees that they will not publicly display the address of the home in any manner whatsoever including but not limited to checking-in via social media.

    Volunteer releases Zelie's Home, its affiliates, members, predecessors, successors, assigns, agents, independent contractors, directors, officers, representatives, attorneys, insurers, and all persons acting by, through, under or in concert with any of them (collectively “Releasees”) from any responsibility or liability for injuries to Volunteer, including without limitation, personal injury, death, and/or damage to or loss of property, arising out of the known and unknown risks associated with these volunteer activities, the non-profit’s negligence, accidental occurrences while visiting or otherwise engaging in activities contemplated by this Agreement.  

    IN WITNESS WHEREOF, each Party has executed this Agreement as the Effective Date.

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  • CONFIDENTIALITY POLICY AND PLEDGE

  • Any information that an employee or volunteer learns about Zelie's Home, or its members or donors, as a result of working for Zelie's  Home that is not otherwise publicly available constitutes confidential information. Employees or volunteers may not disclose confidential information to anyone who is not employed by Zelie's Home or to other persons employed by Zelie's Home who do not need to know such information to assist in rendering services.

    The disclosure, distribution, electronic transmission or copying of Zelie's Home’s confidential information is prohibited. Any employee or volunteer who discloses confidential Zelie's Home information will be subject to disciplinary action (which may include termination), even if the employee or volunteer does not actually benefit from the disclosure of such information.

    I understand the above policy and pledge not to disclose confidential information.

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  • VOLUNTEER INJURY OR ILLNESS

  • Report all on site accidents immediately to the volunteer coordinator. We ask that you notify us of the injury as a report must be completed by the volunteer staff to prevent further incidents.

    If an injury occurs at Zelie’s Home at any time:

    • The volunteer coordinator should be notified immediately that there has been an injury.
    • The volunteer coordinator will determine whether or not additional medical attention is warranted.
    • The volunteer may decline treatment.
    • The incident report is submitted to the Volunteer Coordinator within twenty-four (24) hours.

    Returning to Volunteer from Illness or Any Injury

    A volunteer must meet with the Volunteer Coordinator when returning from an illness or recovering from an injury to reaffirm the volunteer’s ability to function effectively after recovery.

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