Application Form - The Hunger Coalition

Please read thoroughly to understand our policies and the risks and complete the information section.

Your compliance to confidentiality regarding food and service recipients, other participants, and donors involved in The Hunger Coalition is of the utmost importance.

VOLUNTEER CONFIDENTIALITY AGREEMENT, LIABILITY WAIVER and RELEASE

CONFIDENTIALITY

I understand that as a volunteer, I may have access to confidential information about participants or donors who are involved with The Hunger Coalition. I understand that any information I learn about a participant or donor is confidential and that information about a participant or donor cannot be disclosed to anyone, including the participant or donor themselves, outside of The Hunger Coalition staff.  I understand the law provides for possible civil and criminal penalties for disclosure of confidential information.

This includes information I receive whether obtained visually, verbally or in writing by The Hunger Coalition or by direct contact with The Hunger Coalition participants, their families or donors.  Any of this information is to be held in strict confidence in order to protect the rights of all participants and donors.

I recognize that the disclosure of such information by me may cause irreparable harm.  In the event of disclosure of confidential information, the participant or donor may seek any legal remedies against me which may be available.

I agree that I will not:

1. Approach a participant, their family or a donor regarding their status as such or to discuss information learned about them.
2. Reveal to anyone the name or identity of a participant or donor.
3. Repeat or reveal any statements or communications made by or about the participant or donor.  This includes but is not limited to the following:
   1. Addresses, phone numbers, email addresses, family information, medical history, sexual orientation or socioeconomic status
   2. Dollar amounts donated by a donor
   3. Freely gained information of any kind disclosed to me as a volunteer from a participant, staff member or volunteer
4. Take or share photographs of participants or their information (unless prior approval from both Hunger Coalition staff AND the participant, including parents of participant if a minor)
5. Write or publish any articles, papers, stories, social media or other written materials which will contain the names of any participant or information from which the names or identities of any participant or donor can be discerned. If a paper is written about my volunteer work here, I agree that I will submit it to The Hunger Coalition for approval.  

SAFETY

The Hunger Coalition takes safety seriously.  We do our best to ensure that volunteers, staff, participants, donors, vendors, contractors and students avoid any situations that would jeopardize their health and safety.  However, we also recognize that accidents can happen.

I, (and/or if signing for a minor, as a parent or legal guardian on my behalf and the minor’s behalf), understand that my participation or volunteering with The Hunger Coalition involves the possibility of personal injury and property damage.  I understand there may be obvious hazards or hazards that are not obvious. 

I freely choose to participate and completely assume all risk.  In consideration of being allowed to participate or volunteer with The Hunger Coalition, I release, waive, discharge from any and all liability, indemnify and hold The Hunger Coalition, its directors, employees and agents or representatives of any kind, from any and all claims.  The term “claims” shall include, but not be limited to any and all attorney fees, awards, claims, costs, damages, demands, expenses, injuries, judgments, liabilities, losses, obligations and recoveries by me, by my family and/or a third party for personal injury and/or property damage to me or others arising out of or related to my participation or volunteering.           

As a volunteer, I understand that, except as otherwise agreed to by The Hunger Coalition in writing, The Hunger Coalition does not carry or maintain health, medical, or disability insurance coverage for any Volunteer.

I sign this release on my own free will.  This release shall bind me, the minor or ward, if applicable, my family, heirs, personal representatives and assigns.  This release shall be interpreted neutrally and ambiguities, if any, shall not be construed against The Hunger Coalition.  If any term of this release is determined to be invalid for any reason, all other terms shall remain in full force and effect.  This release shall only be modified in writing, signed by The Hunger Coalition and no statements or course of conduct shall modify it.  I am aware that I am releasing certain legal rights for me and others.  I have carefully read and fully understand the above content.  I also agree that The Hunger Coalition shall have the right to take, use, publish and reproduce any photos or videos of me, the minor or ward, if applicable.