Liability & Release Form

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Volunteer Agreement and Release From Liability

In signing this form, I understand and agree to the following terms and conditions related to volunteering my services to Meals on Wheels of the Greater Lehigh Valley. Return this signed and initialed form with the orientation test.

I recognize that as a volunteer I represent the above organization to the public. I accept the responsibility for this status and will conduct myself in a professional manner.

I will not participate in and will report any instances of any sort of harassment, exploitation and/or intimidation. I will work to maintain an atmosphere of physical and emotional safety for everyone associated with the organization: employees, volunteers, clients, and visitors.

I agree to maintain the confidentiality of all volunteers, clients, and donors about whom I have personal and identifying information.

I agree to honor the commitment length and/or frequency of service that I make to the organization. I agree to provide as much notice as is possible in the event that I will be absent from my volunteer shift. I agree to update my personal information and emergency information as changes occur.

I am aware that as a volunteer I expose myself to potential hazards. I am voluntarily participating in this service with the knowledge of the potential hazards involved and hereby agree to accept any and all risks of injury.

I agree that my assignees, heirs, distributes, guardians, and other legal representatives will not make a claim against, or sue, for injury or damages resulting from the negligence or other acts, howsoever caused, by any employee, agent or volunteer contractor of the organization as a result of my participation as a volunteer. I hereby release Meals on Wheels of the Greater Lehigh Valley from all action, claims, or demands that I, my assignees, heirs, guardians, and legal representatives now have or may hereafter have for injury resulting from my participation as a volunteer.

If my volunteer service involves driving an automobile, I acknowledge that I have both a valid driver’s license and automobile liability insurance policy as required by state law. I agree to maintain my license and insurance in good standing for my entire tenure as a volunteer for this organization. I am knowledgeable of and agree to abide by local and state traffic laws. I agree not to drive while under the influence of alcohol and/or other intoxicating substances.

Volunteer Name*

Date

Physical or Mental Abuse and Sexual Abuse and Sexual Molestation Prevention Policy

Meals on Wheels of the Greater Lehigh Valley does not permit actual or threatened acts of physical or mental abuse, sexual abuse, sexual molestation or sexual misconduct (“prohibited conduct”) to occur in the workplace or at any activity sponsored by or related to it. In order to make this “zero-tolerance” policy clear to all employees, volunteers and staff members, we have adopted mandatory procedures that employees, volunteers, family members, board members, individuals and victims must follow when they reasonably suspect, learn of or witness prohibited conduct.

Abuse or molestation means each, every, and all actual, threatened or alleged acts of physical or mental abuse, sexual abuse, sexual molestation or sexual misconduct performed by one person or by two or more persons acting together.

Reporting Procedure

All staff members who learn of or have a reasonable suspicion of prohibited conduct must immediately report it to the CEO. If the victim is an adult, abuse or neglect will be reported by this designee to the local or state police and/or Adult Protective Services (APS) Agency. If a child is the victim of abuse or neglect the designee will report it to the local or state police and/or Child Abuse Agency. Appropriate family members of the victim must be notified immediately of suspected child abuse or neglect.

Investigation & Follow Up

We take allegations of prohibited conduct seriously. Once the allegation is reported we will promptly, thoroughly and impartially initiate an investigation to determine whether there is a reasonable basis to believe that the prohibited conduct has occurred and that it was committed by the target(s) of the investigation. The investigation may be undertaken by an internal team comprised of fellow employees or we may hire an independent third party. We will cooperate fully with any investigation conducted by law enforcement or regulatory agencies and we may refer the complaint and the result of our investigation to those agencies. We reserve the right to place the target(s) of the investigation on an involuntary leave of absence or reassigning that person to responsibilities that do not involve personal contact with individuals or students. To the fullest extent possible, but consistent with our legal obligation to report suspected prohibited conduct to appropriate authorities, we will endeavor to keep the identity(ies) of the target(s) and the alleged victim(s) confidential.

If the investigation substantiates the allegation, our policy provides for disciplinary penalties, including but not limited to termination of the target’s relationship with our organization.

Retaliation Prohibited

We prohibit retaliation against anyone, including an employee, volunteer, board member, student or individual, who in good faith reports prohibited conduct. Retaliation against a participant in the investigation is also prohibited.

Anyone who retaliates against someone who has made a good faith allegation of prohibited conduct or intentionally provides false information to that effect will be subject to discipline, up to and including termination.

Acknowledgment of Receipt of Physical or Mental Abuse or Sexual Abuse, Sexual Misconduct and Molestation Policy

Volunteer Name*

Date

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Liability & Release Form