FOCUS + Fragile Kids - Volunteer Application

















Medical Information





Emergency Contact






References





For good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the undersigned hereby grants to Families of Children Under Stress (FOCUS) permission to take still or moving photographs, films, slides or videos of him/herself, and consents to and authorizes FOCUS, its advertising agencies, news media, and any other persons in FOCUS and its work to use and reproduce said photographs, films, slides or videos, with or without the undersigned’s name, and to circulate and publish the same by any and all means, including but not limited to, magazines, newspapers, slide presentations, television, brochures, Facebook or pamphlets.

FOCUS + Fragile Kids uses an email service through Constant Contact as its main point of contact with volunteers as a whole. These emails are how upcoming volunteer opportunities are accounced.  By continuing I understand that I am signing up to receive emails from FOCUS + Fragile Kids through Contact.  I understand that I can unsubscribe from this service at any point. 

In connection with my voluntary involvement in activities undertaken, and with the participation of support of Families Of Children Under Stress (FOCUS), a nonprofit charitable organization, I hereby agree, for myself, my heirs, assigns, executors, and administrators to release and discharge FOCUS, it officers and directors, employees, agents and volunteers from all claims, demands and actions for injuries sustained to my person and/or property as a result of my involvement in such activities, whether or not resulting from the negligence of FOCUS or anyone working on behalf of FOCUS, and I agree to release and hold FOCUS, it officers and directors, employees, agents and volunteers harmless from any cause or action, claim, or suit arising therewith. I hereby attest that my attendance and involvement in such activities is voluntary, that I am participating at my own risk, and that I have read the foregoing terms and condition of this release. I hereby confirm, represent and warrant that I have never been convicted of or charged with a violent crime, child abuse or neglect, child pornography, child abduction, kidnapping, rape or any sexual offense, nor have I ever been ordered by a court to receive psychiatric or psychological treatment in connection therewith.