submitting this form, I understand that as a volunteer for Community Servings,
Inc., my child will not receive any monetary compensation or any other form of
remuneration from Community Servings, Inc.
I agree to hold Community Servings, Inc. blameless if, in the course of my
child’s volunteer work, he/she is injured, becomes ill and/or requires medical
treatment. I hereby waive any claim
against Community Servings, Inc. resulting from such circumstances.
further understand and agree that my child will perform volunteer services in
the best interest of, and with the utmost respect for, Community Servings’
clients and employees, and in full compliance with the Policies of Community
Servings. I understand that Community Servings may discontinue my child’s role
as a volunteer at any time, for any or no reason.
Privacy & Confidentiality Policy
understand that during the course of my child’s volunteer work, he/she may
learn privileged medical, personal and financial information about Community
Servings employees and clients (“Confidential Information”). Such Confidential Information shall not be
used for any purpose other than the fulfillment of my child’s volunteer duties
with Community Servings, Inc., and at no time will my child or I disclose
Confidential Information without the express written consent of Community
Servings. I agree to discuss the
foregoing with my child and will explain the importance of maintaining client
confidentiality to him/her.
and preservation of the individual rights of all Community Servings, Inc.
clients and agents is a requirement of my child’s association, and by
submitting this form, I attest that my child and I understand and agree to
abide by this Privacy & Confidentiality Policy.
harassment of others because of their race, color, religion, sex, marital status,
sexual orientation, age, national origin, physical or mental disability, or
disabled or veteran status will not be tolerated at Community Servings. In particular, an atmosphere of tension
created by ethnic or religious remarks or animosity, unwelcome sexual advances,
requests for sexual favors, or other conduct of a sexual nature does not belong
in our workplace.
policy of Community Servings is to forbid all unlawful harassment. This policy extends to each and every level
of our operations. Accordingly,
harassment whether by an employee, manager, supervisor, client, or volunteer
will not be tolerated and, after being thoroughly investigated, can lead to
disciplinary action up to and including termination. Any complaints regarding harassment should be
directed toward your Volunteer Coordinator, Vice President of Programs or the
agency Human Resources Department.
By submitting this form, I attest that I have
read and understand Community Servings’ Harassment Policy. I further attest that my child will adhere to
Media Release & Authorization
grant to Community Servings full and complete permission to photograph, record,
tape and otherwise reproduce in any manner my child’s performance, appearance,
photographs, voice, name and likeness and to include all or any thereof in a
video to benefit their meals program, and/or in related programming, throughout
the world, in all media, in perpetuity and for the purposes of promotional
material related to the Community Servings.
This Release & Authorization constitutes a full release as to any
licenses or other agreements that may be derived from this project. All of the
said releases and waivers shall be binding on my heirs, successors,
representatives, assigns, agents, and attorneys. I understand that this release may only be
altered by submission of a signed writing addressed to Community Servings, but
that such writing shall not change or revoke any prior use or disclosure of
media. By submitting this form, I attest
that I understand and agree to Community Servings Media Release &
Authorization and have not relied upon any representation made by Community
Servings in executing this form.