Volunteer Application Form

Your Name (required)

Email (required)

Address

Telephone

Date of Birth

Gender
 Male Female

Emergency Contact Information

Name

Relationship

Telephone

Please read and check the following items:

  If working directly with children, I understand that it may be necessary for Mercy for America’s Children to conduct a background check regarding my driving history, criminal record, personal references, and employment history. I give permission for Mercy for America’s Children to conduct such a background check nationwide and in previous states in which I have resided.

  I understand that the nature of volunteer activities that I may perform in my capacity as a volunteer may involve physical activity and contact with unidentified or unfamiliar persons. Knowing this and in consideration of being allowed to volunteer, I hereby assume full and complete responsibility for any personal injury and or property damage that I sustain or cause during my participation as a volunteer. In addition, I hereby release, hold harmless, and covenant not to file suit against Mercy for America’s Children and any of their employees, board members, volunteer, partners, agents, etc...

  I understand that as a volunteer I may become privy to confidential information about Mercy for America’s Children or the children and agencies with whom we work. I agree to maintain confidentiality of any information marked “Confidential” as well as any information regarding internal procedures, business relationships, personnel information and the like that is not otherwise publicly disclosed by Mercy for America’s Children . I will not use any confidential information in any manner that would be detrimental to Mercy for America’s Children and I will avoid actions that might impair the reputation of the organization.

By checking here, I attest to the truthfulness of all information listed on this application and agree to adhere to all the above terms and conditions.

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