Volunteer Application - Shepherd's Watch Foundation

Volunteer Application, Confidentiality Agreement & Liability Waiver

Illuminating and Targeting Networks Involved in Sex Trafficking
Personal Details
Name:*

First NameLast Name
Date of Birth

MonthDayYear
* You must be at least 18 to volunteer
Gender
Address:*

Street Address

Street Address Line 2

CityState

Zip Code
E-mail:*
example@example.com
Contact number:*
If you use Social Media, please note which platform(s) and let us know your username or handle for each:
How did you hear about our organization?*
Please describe any volunteer work past or present (church, community, etc.): N/A if none*
Please describe any experience/skills that you feel would benefit this organization:*
Please describe any past experiences you have working with this or a similar population (previous experience not required): N/A if none*
In what area(s) would you like to volunteer with our organization (choose all that apply)*

Administration/Data EntryCommunity Awareness/EducationSocial Media, Press & PublicityMarketingFundraisingEvent Planning/Table Set Up, etc.Photography or FilmingWorking Directly with Victims/Survivors (Emergency Shelter/Safe Home)Legal/LegislativeOther *
* If preferred area is not listed, please describe where you feel you would best fit within our organization:
Please tell us why you would like to volunteer with us, if not already described above:*
Are you interested in a short or long-term commitment?

Short TermLong TermNot Sure
Are you willing to attend required training provided via online or in person? (Time commitment approx. 2 hours)*

YesNo
Are there any special issues in your life right now that would have an impact on your commitment and involvement in our organization (relationship, other commitment, etc): N/A if none*
Are there any other pertinent details you feel we should know. (e.g. Personal or family history of sexual abuse, anything that may cause a trigger or emotional suffering for you): N/A if none*
Legal

In caring for victims/survivors, we believe it is our responsibility to seek volunteers that are able to provide healthy, safe and loving relationships. Any specific concerns addressed below can be discussed with our staff.
Have you ever been arrested? If Yes - please list dates, offense and the outcome*
Do you authorize SWF representatives to take, use and publish photographs or videos of yourself (at volunteer events, etc.) to be used on SWF website, social media and/or promotional material? You may revoke this authorization at any time by sending us written communication and it will be removed immediately.*

YesNo
Confidential Background Screening

Depending on your volunteer activity, you may be required to have a Background Screening. If required, there will be a $45 fee that we ask you as the potential volunteer, to cover. You will receive a separate email with more information if this is required. ** Having a criminal record will not necessarily exclude you from volunteering with us.
Permission to Obtain Background Screening
By signing the box below, you are authorizing Shepherd's Watch Foundation to obtain background information based on the information you have provided. Shepherd's Watch Foundation must keep this completed form on file after requesting a background check.

I, the undersigned applicant (also known as “consumer”), authorize, without reservation, Shepherd's Watch Foundation through its independent contractor, to procure background information (also known as a “consumer report and/or investigative consumer report”) about me. This report may include my driving history, including any traffic citations; a social security number verification; present and former addresses; criminal and civil history / records; and the state sex offender records.

I understand that I am entitled to a complete copy of any background information report of which I am the subject upon my written request to Shepherd's Watch Foundation, if such a request is made within a reasonable time from the date it was produced. I also understand that I may receive a written summary of my rights under the Fair Credit Reporting Act.
Your Full Name (Print)*
Driver's License Number or Government Issued ID*
State*
Date*

MonthDayYear
Signature
Waiver of Liability
I hereby WAIVE AND RELEASE, indemnify, hold harmless and forever Discharge SHEPHERD'S WATCH FOUNDATION including its agents, employees, officers, directors, affiliates, successors and assigns (hereinafter, the Released Parties), of and from any and all claims, demands, debts, contracts, expenses, causes of action, lawsuits, damages and liabilities, of every kind and nature, whether known or unknown, in law or equity, that I ever had or may have, arising from or in any way related to my participation in any of the events or activities conducted by, on the premises of, or for the benefit of SHEPHERD'S WATCH FOUNDATION, provided that this waiver of liability does not apply to any acts of gross negligence, or intentional, willful or wanton misconduct.

I understand that the activities and functions in which I participate may be considered (but do not have to be) of a volunteer nature, or for the benefit of a 50l (c)(3). On behalf of myself, my heirs, assigns and next of kin, I waive all claims for damages, injuries and death sustained to me or my property that I may have against the aforementioned Released Parties.

By this Waiver, I assume any risk, take full responsibility, and waive any claims of personal injury, death or damage to personal property associated with my work as a volunteer on behalf of SHEPHERD'S WATCH FOUNDATION including any activities related to SHEPHERD'S WATCH FOUNDATION.

The WAIVER AND RELEASE contains the entire agreement between the parties and supersedes any prior written or oral agreements between them concerning the subject matter of this WAIVER AND RELEASE. The provisions of this WAIVER AND RELEASE may be waived, altered, amended or repealed, in whole or in part, only upon the prior written consent of all parties. The provision of this WAIVER AND RELEASE will continue in full force and effect even after the termination of activities conducted by, on the premises of, or for the benefit of SHEPHERD'S WATCH FOUNDATION, whether by agreement, by operation of law, or otherwise.

I have read, understand, and fully agree to the terms of this WAIVER and RELEASE. I understand and confirm by signing this WAIVE AND RELEASE I have given up considerable legal rights. I have signed the agreement freely, voluntarily, under no duress or threat of duress, without inducement, promise or guarantee being communicated to me. My signature is proof of my intention to execute complete and unconditional WAIVE AND RELEASE of all liability to the future extent of the law. I hereby certify that I am 18 years of age or older, mentally competent to enter into this Waiver, and have read the above carefully before signing.
Name*

First NameLast Name
Date*

MonthDayYear
Date
Signature*
Confidentiality Agreement
PURPOSE

This confidentiality agreement is to protect the identity and privacy of our minors/women. Board members, staff, volunteers, and visitors of Shepherd's Watch Foundation encounter personal and sensitive information about our minors/women and to avoid causing them or their families harm, it is very important to refrain from disclosing any information to third parties.

CONFIDENTIAL INFORMATION

Confidential information should never be discussed in the presence of or shared with or released to third parties, including any files or documents, except under the terms outlined below.

Confidential information includes, but is not limited to, the following:

Identifying information about the minors/women, including name, address, or phone number.
Information relating to the minors/woman’s family.
Information regarding the minors/woman’s legal status, criminal history, or medical information.
Any other information that would identify the minor/woman or potentially place them and/or their family members at risk.
Any information that would disclose the location of our facilities.

TERMS

By signing this Confidentiality Agreement, you agree to the highest ethical standards and to abide by the following provisions:

All communications between board members/staff, volunteers, and women are confidential
The board/staff member or volunteer shall not disclose confidential information to a third party without the consent of the Programs Director and the survivor (if at least 18 years of age).
I understand that as a board/staff member or volunteer, I have a duty to keep a survivor’s information confidential throughout my term as a board/staff member or volunteer, as well as after my employment or volunteer status ends.
I understand that my failure to abide by the terms of this confidentiality agreement may result in the termination of my participation as a board/staff member or volunteer at Shepherd's Watch Foundation.
I understand and agree to the terms of this document and I understand my responsibilities as a volunteer or employee. I understand that disclosing the location of the emergency shelter/safe house may result in prosecution, for all parties involved, under the following felony statutes in the Texas government code 420.071a-d.
I have read, understand and agree to abide by the Confidentiality Agreement.

Yes
Name*

First NameLast Name
Date*

MonthDayYear
Date
Signature*
Should be Empty:

Volunteer Application, Confidentiality Agreement & Liability Waiver

Personal Details

Legal

Confidential Background Screening

Waiver of Liability

Confidentiality Agreement