I Want To Volunteer Consent Form Aaron & Margaret Wallace Foundation Youth Volunteer Parental Consent Form Aaron & Margaret Wallace Foundation 7633 Sunkist Drive, Oakland, CA 94605 (510) 394-4101 Aaron & Margaret Wallace Foundation Youth Volunteer Parental Consent Form Your (son/daughter) will be participating in our Youth Volunteer Program at the Aaron & Margaret Wallace Foundation (AMWFT). On behalf of AMWFT and Staff, we would like to take this opportunity to express to you and your child our appreciation for the generous donation of their time and service. Child’s Name (Required): Parent/Guardian Name (Required): Parent/Guardian’s Address (Required): Child’s Address, (if different): Phone Home #, Work #, Cell # (Required): Parent/Guardian’s Email Address (Required): Do you need Special Accommodations? If so, what: Why Do You Want to Volunteer? (Required) Please indicate the program(s) that most interest you. (Required) What School Do You Attend? List Address, Phone, Your Grade, Principal, Counselor, Teacher VOLUNTEER RESPONSIBILITIES The following list of responsibilities are to be adhered to by all volunteers: 1. Always act in a professional and respectful manner. 2. Be safety conscious at all time. 3. Be courteous to all persons with whom you come in contact. 4. The use of alcohol and controlled substances is absolutely prohibited. 5. Always check in and out with your designated supervisor. 6. A commitment to attend all scheduled assignments is mandatory to continue in the volunteer program. WAIVER AND LIABILITY RELEASE I have read the volunteer responsibilities above and understand that as a volunteer I will adhere to them and act in a respectful manner while representing the AMWFT. I assume the responsibility of mental and physical fitness to participate in the assignment described above, and agree to abide by all rules and requirements of the program. I also understand that failure to abide by the above may lead to my termination from the volunteer program. I understand that I am not considered an employee of AMWFT for the purposes of Workers’ Compensation, but that AMWFT may or may not provide volunteer accident insurance in excess of any other medical insurance I may have. I agree to comply with the AMWFT’s policy on reporting any injuries I incur while under AMWFT’s supervision. I agree to hold harmless AMWFT, its officers, staff, employees and volunteers from and against any and all liability arising out of or in any way connected with my participation in the Youth Volunteer Program. THIS RELEASE SHALL APPLY EVEN THOUGH LIABILITY MAY ARISE OUT OF NEGLIGENCE OR CARELESSNESS ON THE PART OF THOSE DISCHARGED INCLUDING THEIR EMPLOYEES, AGENTS AND VOLUNTEERS. This waiver and liability release shall apply to myself, as well as any of my heirs, executors or administrators. I am of lawful age and legally competent to sign this agreement. I understand the terms and have signed this document as my own free act. I HAVE FULLY INFORMED MYSELF OF THE CONTENTS OF THIS RELEASE BY READING IT BEFORE I SIGNED IT. I REALIZE THAT BY SIGNING THIS DOCUMENT I AM GIVING UP LEGAL RIGHTS TO WHICH I MAY BE ENTITLED. I hereby give permission for my child to be a AMWFT youth volunteer in the Youth Volunteer Program. I understand that my child will be provided with any orientation and training necessary for the safe and responsible performance of his or her duties, and will be expected to meet all the requirements of the volunteer position, including adherence to AMWFT’s policies and procedures. I also understand that my minor child will not receive monetary compensation for the services contributed. I will support my child by respecting their volunteer commitment and will provide transportation, if needed. In case of emergency, please contact (Required): Name, Relationship, Phone By typing your name here you are affixing YOUR Signature to this document (Required): Date (Required): Please return this completed form to Abdul-Jalil al-Hakim. If you have questions about our Youth Volunteer Program, please contact him at (510) 394-4101 or email firstname.lastname@example.org. For more information on other ways you might make a difference in the lives of so many in our community, find out about additional volunteer opportunities, or learn more about AMWFT, we invite you to visit our website at http://amwftrust.org. I Accept the Aaron and Margaret Wallace Foundation’s Terms of Submission.