Qi AC: Volunteer Form

Emergency Contact Information
Emergency Contact Name:*

First NameLast Name
Emergency Contact Phone Number:*
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Secondary Phone Number:
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Email:*
example@example.com
Emergency Contact Relationship:*

Communication
I understand

Please upload your Resumé:*

Please upload your resume as a .pdf file with two references completed
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Please upload your Criminal Record Check for the Vulnerable Population:*

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Volunteer Code of Conduct
Respect

1) Participants, Volunteers and Staff Members
- I understand and agree to keep the information I learn about participants, staff and volunteers confidential.
- If a participant discloses private information that may harm them, I understand that the legal duty to report this information to Qi Staff outweighs any duty of confidentiality.
- I will respect the identities of all participants and support participants with an ability-focused attitude.
- I will be welcoming to all abilities.
- I will decline to borrow/lend money and/or property from participants.
- I will refrain from accepting gifts, tips, or gratuities from participants.
- I will maintain a professional boundary with participants.This includes refraining from giving personal contact information and communicating through social media sites.
- I will be aware of each participant’s support needs and do my best to make them feel comfortable.
2) Yourself
- I will push myself to try new activities and take on new roles that I may not at first feel comfortable trying.
- I will bring my prior experience to add an enriching experience for everyone.
- I will not be afraid to reach out Qi Adventure Club staff, other volunteers and participants to ask questions and receive support.
- I care about ethical professional conduct and will not be afraid to consult other volunteers or staff when facing ethical dilemmas.
3) Program
- I will arrive on time.
- If I need to cancel, I will notify Qi AC as soon as possible.
- I will read the emails sent from Qi AC.
- I will refrain from consuming alcohol, cannabis, and/or illegal drugs or being under effects of alcohol, cannabis, and/or illegal drugs while performing work or work-related duties for Qi AC.
I understand

Assumption of Risk
In consideration of being allowed to participate in any way in Qi Creative Inc (hereinafter called ‘Qi') programs, and related events and activities, or serve as staff or volunteer for the same, I, and/or the minor participant, and/or person for which I am the legal guardian, the undersigned:
Understand that although Qi has taken precautions to provide proper organization, supervision, instruction, and equipment for each activity, course, & program (all of hereinafter called ‘Adventure’). It is impossible for Qi to guarantee absolute safety. Also, I understand that I share the responsibility for safety during any Adventure, and I assume that responsibility. I will make my instructors aware to the best of my ability of any questions or concerns regarding my understanding of safety standards, guidelines, procedures and my ability to participate at any point during any Adventure*

I understand
Understand that risks during an Adventure include but are not limited to loss damage to personal property, injury, permanent disability, fatality, exposure to inclement weather, slipping, falling, insect or animal bites, being struck by falling objects, equipment failure, tripping, falling, immersion in cold water, hypothermia (cold exposure), hyperthermia (heat exposure), attack, and severe social or economic losses that may result from such incident. I also understand that such accidents or illnesses may occur in remote areas without easy access to medical facilities or while travelling to and from Adventure sites. Further, there may be risks not known to me or not reasonably foreseeable at this time*

I understand
I agree
I agree
I agree

Release of Liability, Waiver of Claims, and Indemnifying Release to Qi Creative Inc. Agreement
I understand
I understand
I understand
I understand
I understand
Signature*

Photo and Video Release Form

Qi Creative Inc.
YesNo
I hereby grant to Qi Creative Inc., its subsidiaries, licensees, successors and assigns, the right to use, publish, and reproduce, for all purposes, my and/or my child's name and pictures of me in film or electronic (video) form, sound and video recordings of my voice, and printed and electronic copy of the information described in sections (1) and (2) above in any and all media including, without limitation, cable and broadcast television and the Internet, and for exhibition, distribution, promotion, advertising, sale, press conferences, meetings, hearings, educational conferences and in brochures and other print media. This permission extends to all languages, media, formats and markets now known or hereafter devised. This permission shall continue forever unless I revoke the permission in writing.

I further grant Qi Creative Inc. all right, title, and interest that I may have in all finished pictures, negatives, reproductions, and copies of the original print, and further grant Qi Creative Inc. the right to give, sell, transfer, and exhibit the print in copies or facsimiles thereof, for marketing, communications, or advertising purposes, as it deems fit.

I hereby waive the right to receive any payment for signing this release and waive the right to receive any payment for Qi Creative Inc.’s use of any of the material described above for any of the purposes authorized by this release. I also waive any right to inspect or approve finished photographs, audio, video, multimedia, or advertising recordings and copy or printed matter or computer generated scanned image and other electronic media that may be used in conjunction wherewith or to approve the eventual use that it might be applied.

I acknowledge that Qi Creative Inc. will collect, use, and disclose my personal information in accordance with Alberta's Access to Information Act (ATIA) and Privacy Act (PA), and I consent to such handling of my information as required under these laws.
Name of Child Participant:*

First NameLast Name
Date of Birth:*

DayMonthYear
Date
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Signature of Right Giver/Guardian*
Should be Empty:

Qi AC Volunteer Form

Emergency Contact Information

Health & Wellness

Communication

Volunteer Code of Conduct

Assumption of Risk

Release of Liability, Waiver of Claims, and Indemnifying Release to Qi Creative Inc. Agreement

Photo and Video Release Form