ALMOST HOME FOUNDATION WAIVER OF LIABILITY Please only complete this waiver if you have been asked to by a member of AHF. This waiver is for current volunteers only. If you are interested in joining AHF, please complete the volunteer application on our website.Full Legal Name(Required) First Last Date of Birh(Required) MM slash DD slash YYYY Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email(Required) Phone(Required)Emergency Contact Name(Required) First Last Emergency Contact Phone(Required)Main area of volunteering(Required) Walker Handler Cats Administration Medical Foster Other Consent(Required) The undersigned does hereby acknowledge and assume the risk of participation in any and all activities of Almost Home Foundation, at any location Almost Home Foundation activities take place, and waives any and all claims against PetSmart, PetSmart Charities and PetSmart Charities of Canada when representing Almost Home Foundation at the Bloomingdale and Schaumburg PetSmart adoption locations. He/she/they does hereby acknowledge that he/she/they will release Almost Home Foundation, its officers, staff, members, volunteers, advisors, property owners and/or agents in any location where Almost Home Foundation activities are conducted, of and from all claims which may hereafter develop or accrue to them on account of injury, loss or damage, which may be suffered by said person/minor to any property, because of any matter, thing, or condition, negligence or default whatsoever, and they hereby assume and accept the full risk of danger of any hurt, injury or damage which may occur through or by reason of any matter, thing or condition, negligence or default, or any person or persons whatsoever. It is further agreed and understood that he/she/they shall maintain in full force and effect, a policy of insurance covering medical treatment and all related costs in the event of an injury to him/her/they as a result of his/her/their participation in any and all activities of Almost Home Foundation as aforesaid. He/she/they also agrees that if he/she/they does not maintain in full force and effect a policy of insurance, he/she/they is still liable for medical treatment and all related costs in the event of an injury to him/her/them as a result of his/her/their participation in any and all activities involving Almost Home Foundation as aforesaid. The person executing this release acknowledges that there is a valid consideration to executing this release. The validity of any statement or waiver of rights above under local, state or federal law does not invalidate any other statement or waiver of rights above.Are you a Foster-to-Adopt Volunteer?(Required) Yes No Consent(Required) The undersigned acknowledges and understands the confidentiality agreement as follows. All information concerning adopters, former adopters, donors, volunteers, financial data, Google Drive documents, PetPoint information, and business records of Almost Home Foundation is confidential. Personal and financial information is confidential and should not be disclosed or discussed with anyone without permission or authorization from the Almost Home Foundation Board. Care shall also be taken to ensure that unauthorized individuals do not overhear any discussion of confidential information and that documents containing confidential information are not left in the open or inadvertently shared. This is a basic component of client care and business ethics. The board of directors, volunteers, and adopters rely on volunteer staff to conform to this rule of confidentiality. Almost Home Foundation expects you to respect the privacy of applicants/adopters and to maintain their personal and financial information as confidential. All records dealing with specific applicants/adopters must be treated as confidential. Volunteers are responsible for maintaining the confidentiality of information relating to other volunteers, in addition to clients. Failure to maintain confidentiality may result in termination of your relationship with Almost Home Foundation. This policy is intended to protect you as well as Almost Home Foundation because in extreme cases, violations of this policy also may result in personal liability. Rationale: Confidentiality is the preservation of privileged information. By necessity, personal and private information is disclosed in a professional working relationship. Part of what you learn is necessary to provide services to the applicant or adopter; other information is shared within the development of a helping, trusting relationship. Therefore, most information gained about individual applicants/adopters through this volunteer position is confidential in terms of the law, and disclosure could make you legally liable.Signature(Required)
