Clone of 2024 CCDN Volunteer/Community Service Signup

Volunteer/Community Service Registration form

Please sign up here.
Name:

PrefixFirst NameLast Name
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact number:
E-mail:
Were you referred to volunteer with us?
If yes, by whom? If no, put N/A
If this is a court requirement, How many hours are you required to complete?
How did you hear about our organization?:
I am over 18
If you checked No, please enter your birth date.
Please indicate day of the week and time you are available to volunteer:
Example: Monday's and Wednesdays 12:00 PM-3:00 PM or Special Events Teen Summit, 2 hour shifts morning
Let us know what you're interested in volunteering with.

Other
Please tell is what you hope to gain from volunteering with us:

Other
Emergency contact person:

PrefixFirst NameLast Name
Emergency contact person relationship to you:
Emergency contact number:
Do you have a disability, health issue or particular access requirements that we should be aware of, please state:
Community Care Development Network (CCDN)
Volunteer Agreement & Acknowledgments
Please read each statement carefully and check the boxes to acknowledge your agreement.
Volunteer Policy Acknowledgment:
Hold Harmless & Liability Waiver
I agree to volunteer at my own risk and will not hold the CCDN liable for any injury whilst volunteering.
By filling in your details below you give permission to CCDN representatives to take, use and publish photographic pictures or videos of yourself and / or child / children to be used on CCDN website, social media and promotional material. You may revoke this authorization at any time by sending us a message and it will be removed straight away. So are you happy to be photographed & shared online?
Media Release and Social Media Policy
Mandatory Reporting & Child Protection
Permission to photograph Volunteer child / children:
Enter your child/ren's names above if you're happy that this applies to them too.
Emergency Contact

Please enter the primary emergency contact person information here.
Name

First NameLast Name
Relationship
Phone Number

Area CodePhone Number
Alternate Phone Number

Area CodePhone Number
Background checks

Depending on your volunteer activity, we may require you to have a background check (i.e. working with youth.) Having a criminal record will not necessarily exclude you from volunteering with us.
Signature
Tick to confirm
Should be Empty:

Volunteer/Community Service Registration form

Emergency Contact

Background checks