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Volunteer Waiver/Confidentiality Agreement
Volunteer Waiver/Confidentiality Agreement
Volunteer Waiver/ Confidentiality Agreement
Please read and initial the following statements in Agreement for Assumption of Risk, Waiver and Release of Liability and Indemnification:
The Confidentiality Policy applies to employees, former employees, contractors, consultants, temporary employees, volunteers, board members and all other workers at the Company, including all personnel affiliated with third parties. As a condition of employment and continued employment with the Company, all employees are expected to conduct themselves in a manner which protects confidential information. All non-employee parties covered under this policy are expected to conduct themselves in a manner which protects confidential information. This policy is not intended to prevent disclosure where disclosure is required by law and any legal requirements will take precedence over the Company policy. Access to confidential or non-confidential information contained on internet/intranet/extranet systems shall be based on the job/role needs as determined by the Executive Director or Chair of the Board of Directors as appropriate. Confidential information shall include, but not be limited to, addresses, phone numbers, account information, passwords, pass codes, state or government issued driver’s license or identification card numbers, government passport numbers, birth dates, social security numbers, personal identification numbers, credit card numbers, bank account numbers, other Financial Transaction Devices (as defined in Colorado Revised Statutes 18-5-701(3)), biometric data (as defined in Colorado Revised Statutes 6-1-716(1)(a)), credit history, wage and salary information, medical data, applicant and personnel information, employer, student or military identification numbers and employee background checks. Other information that may be deemed confidential includes, but is not limited to, client information (including pet ownership unless authorized by the client and surrendering party), all donor information (unless specifically authorized by the donor), legal impound/holds. All necessary steps to prevent unauthorized access to this information shall be taken. 1. It is recommended that any information that users consider sensitive or vulnerable should be encrypted. 2. Removing any asset or media that contains confidential information from the Company premises (computers, laptops, hard drives, flash drives, backup tapes/disks, paper records, cloud-based storage) is prohibited without explicit prior approval by the Executive Director. 3. If confidential information is approved for removal from the Company premises, under no circumstances should it be accessible to any individual or individual(s), including, but not limited to, family members, computer service technician, without the explicit prior approval by the Executive Director.
Please sign your initials in the boxes below each question
I have read and understand the above Confidentiality Policy of the Ark-Valley Humane Society, Inc. and I agree to abide by the policy.
I agree to comply with all the rules and regulations which may be established from time to time by AVHS.
I agree to disclose any physical or psychological limitations to appropriate staff before participating in any activity. Since I may be interacting with animals, healthy and sick, big and small, and may be lifting, carrying, moving, or otherwise engaging in physical labor, I will be mindful of my own limitations and will inform staff immediately of any such limitations.
I agree to hold absolutely confidential all information that I may obtain concerning patrons or animals while volunteering at AVHS.
I fully understand that Ark-Valley Humane Society expects high standards of moral and ethical treatment of animals under its care. I agree to adhere to these standards in my voluntary capacity and exercise compassion, care and positive training methods with all animals
I agree to treat all AVHS staff, volunteers, property, tools, and equipment with respect and kindness. I will also return all AVHS property when my volunteer relationship ends.
I agree to treat patrons and other guests of Ark-Valley Humane Society with courtesy, sensitivity, and professionalism. I will seek management for any questions or situations beyond my training.
I agree to report any relevant information regarding an animal in a timely manner. If bitten or otherwise injured, I will immediately alert management and/or staff.
I give AVHS and its sponsors permission to use and publish photographs and videos taken of me as a volunteer, such as in their newsletters, websites and online media, for publicity, promotional or educational purposes.
I acknowledge all services provided by volunteers will be performed on a strictly volunteer basis, and that I will receive no pay or compensation of any kind, that I will not be an employee of AVHS nor otherwise derive any benefits normally available to employees of AVHS, and that AVHS shall incur no liability of any nature as a result of my volunteering for AVHS.
I acknowledge that I am responsible for providing my own medical, liability, and auto insurance while volunteering for AVHS. I understand that I am not covered by workers’ compensation, including when driving a vehicle or transporting an animal.
I understand that either AVHS or I can terminate this relationship at will
I am voluntarily participating in the activities of AVHS with full knowledge of the risks and dangers involved. I understand that as a volunteer, I will be in close contact with dogs, cats and other animals. Many of these animals are strays and may be scared, hurt or injured. Some animals may have unpredictable temperament. Such work entails risk of personal injury due to proximity to animals, equipment, driving, and other considerations. These include, but are not limited to, being bitten, kicked, clawed, tripped, exposed to parasites, such as fleas, ticks and ringworm, and possibly exposed to infectious diseases, such as rabies. These risks may be caused by my actions or the actions of others.
I (and my parent(s)/guardian(s) if applicable) knowingly assume all risks of injury, whether identified above or not, and risk of death or damage to myself and/or my personal property may result from my voluntary choice to participate in the activity described in this Agreement and assume full responsibility for participation in this activity.
I (and my parent(s)/guardian(s) if applicable) understand that I am solely financially responsible for any and all necessary medical care resulting from injury occurring while volunteering at AVHS, whether on-site or off-site at associated AVHS activities.
In consideration of being permitted to perform volunteer services for Ark-Valley Humane Society, I, on behalf of myself, my heirs, and personal representatives, hereby release, discharge, indemnify and hold harmless AVHS and its assigns, successors, agents, staff, board of directors, employees, sponsors, and representatives from any and all claims, causes of action, or demands of any nature or cause whatsoever, including costs and attorney fees, arising out of or relating to my volunteering with AVHS.
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Parent(s)/Guardian(s) Signature(s) (required for volunteers under the age of 18)
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