• Date of Birth*
     - -
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • I wish to volunteer my services through the RSVP program at Pittsburgh Cares, a Pennsylvania non-profit, charitable corporation. 

    In consideration of Pittsburgh Cares providing me with the opportunity to perform some volunteer activities and intending to be legally bound hereby, I waive, release, and forever discharge Pittsburgh Cares and its directors, officers, members, employees, and agents from any and all liability, causes of action, suits, proceedings, damages, judgments, claims and demands whatsoever arising out of my participation as a Pittsburgh Cares volunteer or in any Pittsburgh Cares related activity.

    Moreover, I am aware that there are inherent risks of injury to myself, my property, and third parties arising from such volunteer activities and I voluntarily assume all such risk and damage arising therefrom, and intending to be legally bound hereby, will release Pittsburgh Cares and its agents, servants, and employees from any and all liability, actions, causes of action, claims and demands of every kind and nature whatsoever which I now have or which may arise out of or in connection with my volunteer services.

    As a volunteer of RSVP, understand that in my capacity as an RSVP volunteer I may come into contact with confidential information. I agree to protect this information to the best
    of my abilities as a volunteer and not to disclose it during or after my service as a volunteer has ended. 

    I understand that representatives of Pittsburgh Cares and/or the news media may occasionally take photographs or shoot film footage of myself and volunteers and I give my permission for my image to be used for reasonable and legitimate business purposes by Pittsburgh Cares in occasional publicity materials.

  • Date Signed*
     - -
  • Equal Employment Agency

    RSVP at Pittsburgh Cares  is an equal opportunity Agency. Enrollment is done without regard to race, color, religion, national origin, sex, age or disability. RSVP provides reasonable accommodations to the known disabilities of individuals in compliance with the Americans with Disabilities Act.  For accommodation information or if you need special accommodations to complete the application process, please contact RSVP at Pittsburgh Cares at rsvp@pittsburghcares.org or call 412-471- 2114 ext. 202. 

    Accident Insurance

    As an RSVP volunteer, you will be covered by accident and personal liability insurance, while performing volunteer duties.  This coverage is automatic and free of cost to you, as long as you are an active, enrolled member of RSVP.  The insurance provided by RSVP at Pittsburgh Cares is secondary coverage and is not primary insurance.


    Thank you for any information you have provided. Your information is never sold, shared, or used outside of RSVP, Allegheny or Beaver counties, governments, or the Corporation for National and Community Service.

    • VOLUNTEER INFO (optional section) 
    • Volunteer Travel Benefit

    • Volunteers serve without compensation, but may be eligible to receive the RSVP volunteer travel reimbursement.  

      Eligibility requirements: 

      • Complete the field below 
      • Be the individual driving the automobile or taking public transportation to and from your volunteer assignment
      • Site Supervisor must complete and submit the required documentation for the volunteer travel reimbursement

      As the RSVP volunteer, you understand that if you use your personal automobile in volunteer service, you will keep in effect automobile liability insurance equal to the minimum limits required by the state.

       

    • Volunteer Interests

    • Rows
    • Additional Volunteer Information

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