Brookings Area United Way Volunteer Form

Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Parent's Name (If under 18)

First NameLast Name

Parent's Phone Number (If under 18)

Please enter a valid phone number.Format: (000) 000-0000.

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Describe any special skills, training, hobbies, or interests.

I am able to:

What volunteer opportunity are you registering for?

What organization are you with?

Please list the name of your business or organization you are apart of

Please indicate how many hours you would like to volunteer

Please select the weekdays you are available to volunteer

Have you ever volunteered with us before?

Emergency Contact Name

First NameLast Name

Emergency Contact Relationship

Emergency Contact Phone Number

Format: (000) 000-0000.

I hereby grant Brookings Area United Way permission to use my likeness in photographs and/or video in any and all of its publications, including Web space, and in any and all other media, whether now known or hereafter existing, controlled by Brookings Area United Way, in perpetuity, and for other use by the organization. I will make no monetary or other claim against the Brookings Area United Way for the use of the photographs and/or video. I hereby grant the Brookings Area United Way the right to video record and/or photograph me and use the clips and/or photographs in promotional purposes. I waive the right to inspect or approve the finished project, including written or electronic copy. Additionally, I waive any rights to compensation arising or related to the use of the videos for educational or promotional purposes. I hereby hold harmless and release the Brookings Area United Way, the videographer, photographer, their offices, employees, agents, or designees from liability for a violation of any personal or proprietary right I may have in connection with use.

By typing my name and signing, I confirm that I have read and understood the statement above and voluntairily agree to it's terms.

Please Print Name in Full

First NameLast Name

Media Release Agreement/Signature

Parent Signature (If under 18)

I, the undersigned, in consideration of my participation as a volunteer or staff with Brookings Area United Way, hereby agree to the following Confidentiality Agreement. I understand that I may be given access to confidential and/or proprietary information to the extent necessary in order to perform my duties as a volunteer with Brookings Area United Way. I shall not, at any time either during or subsequent to this participation with Brookings Area United Way, make unauthorized disclosures or unauthorized use of any information that is considered to be proprietary or confidential by Brookings Area United Way. Proprietary information includes, but is not limited to, all information, data, reports, analyses, processes, know-how, designs, plans, marketing data, business plans and strategies, negotiations and contracts, research, and volunteer, donor or vendor lists, compilations, trade secrets, and confidential information, whether in written, oral or electronic form. Confidential information includes, but is not limited to, any personal information of any Brookings Area United Way employee, volunteer, agency partner, or donor, whether in written, oral or electronic form. All employer records and information relating to Brookings Area United Way or its volunteers, agency partners, and donors are confidential, and I will treat all matters accordingly. This includes any information protected under any applicable state or federal privacy law. No Brookings Area United Way- related information, including without limitation, documents, notes, files, records, oral information, computer files or similar materials (except in the ordinary course of performing duties on behalf of Brookings Area United Way) may be removed from Brookings Area United Way premises without permission from Brookings Area United Way staff. Additionally, the contents of Brookings Area United Way’s records or information otherwise obtained in regard to business may not be disclosed to anyone, except where required for an authorized business purpose and/or required by law. I will not disclose any confidential information, purposefully or inadvertently (through casual conversation), to any unauthorized person inside or outside Brookings Area United Way. If I am unsure about the confidential nature of specific information, or whether specific information may be protected under state or federal law, I will ask the Brookings Area United Way staff member supervising my actions as a project for clarification before disclosing the information. Proprietary information and trade secrets are created at substantial cost and expense to Brookings Area United Way. Unauthorized use or disclosure of confidential or proprietary information would cause irreparable injury to Brookings Area United Way. I agree that monetary damages would not be a sufficient remedy for any breach of this agreement by me, and that, in addition to all other remedies, Brookings Area United Way shall be entitled to seek (a) specific performance and (b) injunctive or other equitable relief as a remedy for any such breach, and I further agree to waive any requirement for any bond in connection with such remedy. When I cease my participation as a volunteer with Brookings Area United Way, I will return all Brookings Area United Way-related information and property that I have in my possession, including without limitation documents, files, records, manuals, information stored on a personal computer, personal data assistant or computer disk, supplies, and equipment or office supplies.

By typing my name and signing, I confirm that I have read and understood the statement above and voluntairily agree to it's terms.

Please Print Name in Full

First NameLast Name

Signature

Parent Signature (If under 18)

I, the undersigned, in consideration of being permitted to volunteer at Brookings Area United Way, I hereby release, waive, discharge, covenant not to sue, and hold harmless Brookings Area United Way, participants, promoters, advertisers, owners and lessees of premises used to conduct events, and each of them, their directors, officers, agents and employees, (collectively, the "Releasees") of and from any and all liability, to the undersigned, my personal representatives, assigns, and heirs, for any and all loss or damage and any claim or demands therefore in account of injury to the person or property arising out of or related to my participation as a Brookings Area United Way volunteer, whether caused by the negligence of the releasees or otherwise.

By typing my name and signing, I confirm that I have read and understood the statement above and voluntairily agree to it's terms.

Please Print Name in Full

First NameLast Name

Signature

Parent Signature (If under 18)

How did you hear about this volunteer opportunity?

Volunteer Registration Form

Contact Information

Skills

Availability

Emergency Contact Information

Media Release Statement

Confidentiality Statement

Liability Waiver