Mentor & Teen Leader Application

By submitting the Volunteer & Mentor Enrollment Form, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this enrollment application may result in my being removed as a volunteer. I understand that my services are being offered on a voluntary basis, without anticipation of financial remuneration, or the promise or expectation of compensation, benefits or future employment. I understand that I am NOT an employee of the federal government or of the Fuller Center, and I agree to serve without monetary compensation. I understand that the Fuller Center will not provide me with accident or medical insurance, and is therefore not responsible for any accidents or medical expenses that I may incur during the course of my volunteering. I also understand that I am not covered by workers’ compensation laws in connection with my volunteer affiliation. I understand that my participation as a volunteer may involve certain risks which will be explained to me. I release the Fuller Center, its Board or officers, agents, and employees from any losses, damages, costs and expenses, claims, demands, rights, and causes of action resulting from any personal injury, death, or damage to property arising from my volunteer activity, and waive any right of recovery that I might have to bring a claim or a lawsuit against them for any personal injury, death or other consequences occurring to me arising from my volunteer activity. I understand that I am to report any on-the-job injury or illness, no matter how minor. I authorize emergency medical care if it should become necessary. I also understand that as a volunteer, I may become privy to confidential information about my assigned nonprofit organization. I agree to maintain the confidentiality of any information marked “confidential” as well as any information about the Fuller Center’s internal procedures, business operations, existing or prospective donor information, proprietary business information, personnel information, client information, and the like that is not otherwise publicly disclosed by the organization. I will not use any confidential information in any manner that would be detrimental to the organization and I will avoid any action that might impair the reputation of the organization. I acknowledge and agree that any intellectual property I may create in the course of my activities at the organization shall be the property of the organization. I agree to abide by all applicable rules and regulations of the organization and any of the department or units where I engage in volunteer activities. As a part of the screening process, I authorize the Fuller Center to conduct a criminal background check. As a condition of volunteering, I give permission the Fuller Center to conduct a background check on me, which may include a review of sex offender registries, child/domestic abuse, and criminal history records. I understand that if appointed, my position is conditional upon the organization receiving no problematic information on my background. I hereby release and agree to hold harmless from liability the Fuller Center, employees and volunteers thereof, or any other person or organization that may provide such information. I understand that, regardless of previous appointments, the Fuller Center is not obligated to appoint me a volunteer position. If appointed, I understand that, prior to the expiration of my term, I am subject to dismissal by the Volunteer Manager. If my volunteer work includes access to financial information such as credit card or other financial data, a credit report may also be obtained. A separate background release form will be provided to me for purposes of this authorization. If my duties include driving on my assigned nonprofit organization’s business, I understand that I must possess a valid driver’s license and that I will be subject to a driver’s license background check. I understand that if I use my personal automobile to drive to and from my volunteer station, I will keep in effect automobile liability insurance equal to or greater than the minimum required by the state. I understand that to remain in compliance with Palm Beach County Health Department regulations, I will be subject to paperwork certifying that I am safe to work with children. I understand that some of this paperwork must be repeated on an annual or biannual basis. I understand that I must complete this paperwork before beginning my volunteer service, and that I must complete it whenever necessary to continue volunteering at the Fuller Center. I am performing volunteer service for my own purposes, and I may stop performing this service at any time. I agree that if the Fuller Center asks me to stop this service, I will do so immediately. I understand that the Fuller Center, Inc. does not discriminate against any person on the basis of race, religion, creed, national origin, marital status, sex, gender, socioeconomic class, age, sexual orientation, or disability. I have read and I understand the forgoing terms and conditions, and agree to them as a pre-condition to my serving as a volunteer of the Fuller Center.