Confidentiality: I acknowledge that all Lutheran Family Services Rocky Mountains (LFSRM) client-related or donor-related information is to be kept confidential by the volunteer. Client information, including but not limited to client-related records and the information contained in them, may be released only if authorized by law and in accordance with Lutheran Family Services Rocky Mountains (LFSRM) policies and procedures. I acknowledges that policies and procedures with regard to client or donor confidentiality have been explained to them and that I understands those policies and procedures.
References: I hereby give my consent for the Lutheran Family Services Rocky Mountains (LFSRM) to contact my references
Media: I hereby consent, authorize and grant permission to the employees or representatives of Lutheran Family Services Rocky Mountains for the collection and use of my personal images by photography and audio/video recording and do further consent to publication, circulation, or dissemination of said media for any purpose Lutheran Family Services Rocky Mountains deems appropriate.
LFSRM Publications: I hereby give my permission for LFSRM to send me newsletters and other agency publications via email or postal mail.
Reporting: I Agree to submit a monthly record of my service. I also agree that all time, mileage and donation information indicated on reporting forms that I submit to Lutheran Family Services Rocky Mountains is true and complete, unless I notify LFS RM in writing of errors or omissions within 5 business days of original submission.
Electronic Submission Forms: I Hereby agree that my typed signature on forms electronically submitted to Lutheran Family Services Rocky Mountains represents my written signature.
Background Check: I understand that to work directly with clients of Lutheran Family Services Rocky Mountains, I must consent to a background check to be conducted by LFS RM or myself, including motor vehicle record check if work includes driving LFS RM clients.
Withdrawal of Consent: I understand I can withdraw my consent to this release agreement at anytime in writing to Lutheran Family Services Rocky Mountains at the address listed below.
I have read, understand and commit to the terms stated above. I declare that my answers and all statements made by me herein are true and correct