Volunteer Signature a. Xxxxxxxxx's signature verifies voluntary service time donated. b. PARENT/GUARDIAN SIGNATURE. (if Volunteer is under legal age of majority). 17.
Volunteer Signature. On behalf of Foresight (North East Lincolnshire) Ltd Staff Name: Staff Signature: Date:
Volunteer Signature. Board Designate Signature This Agreement will be stored by the Principal in a secure location.
Volunteer Signature. Volunter (print): Date: [if under 18 years of age] Volunteer First & Last Name (print): Age: Volunteer Parent or Guardian First & Last Name (print): Volunteer Parent or Garduian Signature: Date: TNC Supervisor Signature: TNC Supervisor (print): Xxxxx Xxxxxxx Date: THE NATURE CONSERVANCY DAILY SELF-CERTIFICATION HEALTH QUESTIONNAIRE RELATING TO COVID-19 SYMPTOMS – FOR THIRD PARTIES Instructions: All individuals engaging in work with TNC employees or volunteers in groups of 2 or more must review all of the following questions at least once a day to determine if they may have symptoms of COVID-19 and to enable TNC to follow proper precautions. This self-certification must be done daily before conducting any group work (2 or more). The intent of this document is to identify any unexplained or new symptoms that could indicate possible COVID-19. It is not intended to cover recurring symptoms that are solely related to other health conditions (e.g. allergies). With these caveats, if the answer to any question is YES, you must alert your TNC contact listed below and contact your medical provider. In no event should you engage with any TNC employee or volunteer, or if you are already at a TNC location or event, you must stop work and go home. We thank you in advance for your transparency and cooperation to maintain a safe and healthy work environment. Individuals should NOT send answers to each question but instead only send the overall answer of ‘self-certification no’ or ‘self-certification yes’ which is described in detail at the end of this questionnaire. Privacy: Maintaining privacy of an individual’s health information is critical. TNC only collects enough information to make sure we provide everyone with a safe workplace during the COVID-19 pandemic. For this reason, you should not provide any information that is not specifically requested by this questionnaire. For detailed information about how TNC will use and handle your information from this daily questionnaire, you may request the full the TNC Daily Self-Certification Health Questionnaire Privacy Notice. Concerns about safety can be reported to your TNC contact and/or the TNC Office of Ethics & Compliance. In the past 24 hours, have you experienced: Fever (100.4 degrees F or higher): □ Yes □ No Chills: □ Yes □ No Repeated shaking with chills: □ Yes □ No Fatigue: □ Yes □ No Persistent Dry Cough: □ Yes □ No Muscle or Body aches: □ Yes □ No Sore throat: □ Yes □ No Diarrhea, nausea or vomiting: □ Yes □ No...
Volunteer Signature. On behalf of the(insert name) Methodist Church
Volunteer Signature. If Volunteer is under 18 years of age, the signature of the parent or legal guardian is required. I, the parent or legal guardian of , represent that I have fully reviewed this Agreement, that I understand and consent to its terms, and that I authorize Volunteer’s participation in the Activities under the terms of this Agreement. Printed Name of Legal Guardian/Parent: __________________________________________________ Signature of Legal Guardian/Parent: _____________________________________________________
Volunteer Signature. Date: Administrator associated with SAS duties section. SAS Associated Account Number: I confirm this employee has completed all required mandatory training for FNSBSD. Initial: This SAS Contract ☐ IS ☐ IS NOT for duties related to coaching a high school level varsity or junior varsity sport. If it is, I have verified this employee has a current AK State Coaching Certificate or first season approved ASAA waiver and a valid first aid card. Initial: Signature: _ Date This SAS Contract ☐ IS ☐ IS NOT for work in a school building other than employee’s regular work location. If it IS, employee MUST have regular supervisor’s permission to accept an SAS contract for another school prior to submission.
Volunteer Signature. The library understands that the volunteer is a valuable addition to the library, and agrees to: Offer the full support of library staff Provide orientation to the library and library system Provide training and supervision for volunteer assignments Provide recognition Match the volunteer with a suitable assignment Employee in Charge signature Date
Volunteer Signature. Date: Note: If you have any concerns about the requested information, please feel free to speak to any member of the program or ministry staff. Attachment C: VULNERABLE ADULT VOLUNTEER APPLICATION SHORT FORM Westminster Presbyterian Church, Minneapolis, MN This form is to be completed by Westminster Presbyterian Church volunteers if they have signed a Vulnerable Adult Volunteer Application form within the last 5 years. I have read the Vulnerable Adult Safety Policy. Yes No The last time I volunteered with a vulnerable adult activity at Westminster was: . (mm/dd/yyyy) I verify that the information that I provided on the Vulnerable Adult Volunteer Application dated is still correct. If any information is not now correct, please provide the currently correct information: _ _ Volunteer Printed Name _ Volunteer Signature Date: Address: Phone: Email Address: _ Attachment D: VULNERABLE ADULT SAFETY POLICY INCIDENT REPORT FORM Westminster Presbyterian Church, Minneapolis, MN Date of Incident: Time of Incident: Name of vulnerable adult involved: (A separate form must be completed for each vulnerable adult involved in order to keep the information confidential.) Address of vulnerable adult: _ _ Phone number of vulnerable adult: Name of guardian: Location of incident: _ Name of person(s) who witnessed the incident: Name: Phone: Name: Phone: Name: Phone: Please describe the incident as seen/heard and actions taken: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Printed Name of Person Making Report _ Signature of Person Making Report Date: (Use back of this form if needed.) Attachment E: VULNERABLE ADULT TRAINING FOR VOLUNTEERS AND STAFF Westminster Presbyterian Church, Minneapolis, MN 1. Discuss the characteristics of a vulnerable adult.
Volunteer Signature. Participant is less than 18 years old. I sign this release on his/her behalf.
