New Volunteer Registration Form

Volunteer Details:

Full Name

First NameLast Name

Home Address (Business/Organization Address if part of a group)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Format: (000) 000-0000.

E-mail

example@example.com

Are you signing up as an individual or as a representative of a group?

Please Specify Your Group

Please provide emergency contact information:

Rows	Emergency Contact Name	Emergency Contact Phone Number	Hospital Preference
1

Are you (or, in the case of a group, all members) 16 years or older?

Volunteer Expectations
Volunteers are expected to follow our guiding principles of creating a person-centered, team-oriented, and professional environment by:

· Always treating others with dignity and respect

· Fostering teamwork and participation

· Reporting inappropriate behavior or comments that may be considered discriminatory, harassing, abusive, offensive, or unwelcome. CCRI will not tolerate discrimination, harassment, or any behavior or language that is abusive, offensive, or unwelcome.

If you ever see or suspect a client is being mistreated, disrespected, neglected, or abused by another person, including: staff, volunteers, family members, or a member of the public, report concerns to the CCRI Volunteer Manager or another member of CCRI’s administrative team immediately.

Drugs and Alcohol Policy
For the safety and wellbeing of the people we support, team members, and volunteers, CCRI maintains a drug and alcohol-free work environment. Volunteers are not allowed to smoke or chew tobacco in the presence of the people we support, or on any CCRI property (including vehicles, work sites, the parking lot, or other outdoor areas surrounding a site or workplace). Attending volunteer events while under the influence of drugs or alcohol is strictly prohibited.

Confidentiality Agreement
In volunteering with CCRI, confidential information may be disclosed to a volunteer by staff or clients. CCRI volunteers agree to hold confidential information in strict confidence, without divulging directly or indirectly the confidential information to others.

Media Release
You consent to allow CCRI to interview, photograph, and take video and audio recordings of you, understanding they could be used for promotional materials including, but not limited to, newspaper, television, radio, books, brochures, magazines, social media and website publications in such a manner and at such times and places as CCRI determines.

Release of Liability

You authorize CCRI Inc. to seek emergency medical treatment in case of an accident, injury or illness and you have provided the name and phone number of the individual who should be contacted in case of an emergency. You understand that while volunteering you are not considered an employee. So, if you are injured while volunteering at CCRI, you are not covered by the Minnesota Worker’s Compensation Law and you agree not to hold employees and/or directors responsible for any injury or illness occurring while volunteering.

Signing below signifies you agree to all the above expectations, policies, agreements, and releases. If you are a volunteer group leader, you agree to all the above expectations, policies, agreements, and releases on behalf of your group members. Signing below also signifies you understand you are a volunteer and will not be paid for the hours you are volunteering with CCRI.

Signature