Volunteer Application

Name:

* indicates a required field

Name Title

Mr.

Mrs.

Ms.

Dr.

First Name *

Last Name *

Preferred Name

Race or Origin:

Race or Origin

Are You Volunteering as Part of a Group or Company?

Group or Company

No

Yes

Company or Group Name

Contact Information:

Country *

Street Address *

City *

State *

Zip Code *

Preferred Method of Contact:

Phone Number *

Phone Number Type *

Email *

Date of Birth *

Gender

Male

Female

In Case of an Emergency:

First Name *

Last Name *

Phone Number *

Phone Number Type *

Relationship *

Are You a Veteran?

Veteran?

No

Yes

Volunteer Opportunities of Interest:

Please select all that apply.

Interests

Meal Delivery

Meal Packaging

Special Events

For Delivery Volunteers:

Do you have a valid driver's license?

No

Yes

Do you have valid car insurance?

No

Yes

Reminder preference:

Text

Phone Call

Each day we have open routes, either due to volunteer cancellations or because the need exceeds the number of volunteers we have available. Would you like to receive our weekly email detailing open routes for you to consider?

No

Yes

Release and Waiver of Liability

The Volunteer desires to work as a volunteer for Meals on Wheels and engage in the activities related to being a volunteer. The Volunteer does hereby freely, voluntarily and without duress execute this Release and Waiver of Liability under the following terms.

Waiver and Release: Volunteer does hereby release and forever discharge and hold harmless Meals on Wheels and its successors and assigns from any and all liability, claims and demands
of whatever kind or nature, either in law or in equity, which arise form Volunteer’s work for Meals on Wheels. Volunteer understands and acknowledges that this Release discharges Meals on Wheels from any liability or claim that the Volunteer may have against Meals on Wheels with respect to any bodily injury, personal injury, illness, death or property damage that may result from Volunteer’s work for Meals on Wheels.
Medical Treatment: Except as otherwise agreed by Meals on Wheels in writing, Volunteer does hereby release and forever discharge Meals on Wheels from any claim whatsoever that
arises or may hereafter arise on account of any first aid, treatment or service rendered in connection with the Volunteer’s work for Meals on Wheels.
Assumption of Risk: The Volunteer understands that the work for Meals on Wheels may include a variety of activities including, but not limited to: working in the Meals on Wheels
office; food preparation; moving and transporting of business supplies and/or food stocks incidental to the operation of the agency; and the delivery of meals whether using Volunteer’s personal vehicle or a vehicle owned by Meals on Wheels.
Meals on Wheels Vehicle: A Volunteer authorized to use a motor vehicle owned by Meals on Wheels is insured under the applicable Meals on Wheels motor vehicle liability insurance
policy. In all other cases, however, the Volunteer understands that Meals on Wheels does not
carry or maintain health, accident, liability (including without limitation motor vehicle liability), property loss or damage (including without limitation motor vehicle collision damage), medical or disability insurance coverage for any Volunteer or the property of any Volunteer. Each Volunteer is expected to obtain his or her own vehicle, medical or health insurance coverage.
Photographic Release: Volunteer does hereby grant and convey unto Meals on Wheels all right, title and interest in any and all photographic images and video or audio recordings made by Meals on Wheels during the Volunteer’s work for Meals on Wheels, including but not limited to any royalties, proceeds or other benefits derived from such.
Information Release: Volunteer does hereby grant and convey unto Meals on Wheels the right to provide name and contact
information to other volunteers (when requested) to be used for the purposes of finding a substitute volunteer when needed.
Other: Volunteer expressly agrees that this Release is intended to be as broad and inclusive as permitted by the laws of the State of South Carolina, and that this Release shall be governed by and interpreted in accordance with the laws of the State of South Carolina. Volunteer agrees that in the event that any clause or provision of this Release shall be held to be invalid by any court of competent jurisdiction, the invalidity of such clause or
provision shall not otherwise affect the remaining provisions of this Release which shall continue to be enforceable.

Release and Waiver of Liability *

I acknowledge that I have completed volunteer orientation, and I understand that a background check may be necessary.

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