I certify that I have answered the above questions truthfully and have not withheld any information relevant to my application. I understand that any falsification, misrepresentation, or omission, as well as any misleading statements or omissions of the application information, attachments, and supporting documents generally will result in denial of volunteer relationship. I will abide by the rules and policies of Anchor of Hope Foundation. I understand that volunteer placement can be terminated at any time, with or without cause, and with or without notice, at the option of Anchor of Hope Foundation or myself. Anchor of Hope Foundation's programs recognize and insist that all clients, volunteers and caregivers’ rights to confidentiality must be fully protected. Therefore, I hereby agree to keep all medical and personal information regarding program clients and their families or guardians confidential. I will not discuss such information with my family, friends or casual acquaintances or use in written form any identifying information such as name, birth date, distinguishing characteristics or description of the child/participant. In the consideration of the permission granted by Anchor of Hope Foundation for me to participate in activities associated with Anchor of Hope Foundation, I hereby release and waive any and all claims which could be asserted against Anchor of Hope Foundation or Dayspring Presbyterian Church, and their officers, agents and employees (the "Released Parties") by me, my personal representative, heir(s), on account of my injuryor death, or damage to my property arising out of my participation in activities associated with Anchor of Hope Foundation.
By typing my name below I signify it as my legal signature.