VOLUNTEER APPLICATION

What's your email address?

Your information


Required fields are marked with an asterisk (*).
First Name *
Last Name *
Address *
State
ZipCode
Mobile Phone *

For example, 123-456-7890
SMS (text) messaging:
You may opt-in to receive SMS (text) for Sickle Cell Foundation of Georgia volunteer activities, including shift reminders and cancellations.

To opt-out, reply STOP to any SMS message OR update the SMS opt-in setting in your profile.
Home Phone *
How did you hear about us?
Gender *
Special Skills




T-Shirt Size





Birthdate

A valid date as MM/DD/YYYY (for example: 11/30/2015)
Do you hold any memberships in a group, sorority, fraternity, organization, social group etc.?
Do you have any allergies, medical, or special conditions that we should be aware of?
Do you have any health challenges that we should be aware of?
Volunteer Agreement - I have completed and reviewed this volunteer application and attest that the information provided is true. I do understand that the Sickle Cell Foundation of Georgia, Inc. may require additional forms to be completed for a backgroun *
Applicant Signature
Date

A valid date as MM/DD/YYYY (for example: 11/30/2015)

Disclaimer

VOLUNTEER WAIVER & RELEASE OF LIABILITY FORM
VOLUNTEERS MUST COMPLETE THE WAIVER AND RELEASE FORM PARENT/LEGAL GUARDIAN SIGNATURE IS REQUIRED IF VOLUNTEERS IS UNDER AGE. WAIVER AND RELEASE FORM RELEASE OF LIABILITY
In return for being allowed to participate in Sickle Cell Foundation of Georgia, Inc. volunteer activities and all related activities, including any activities incidental in such participation (“Volunteer Activities”), the undersigned Volunteer or Parent/Legal Guardian of Volunteer if Volunteer is under age 18 (hereafter referred to using “I”, “me” or “my”) releases and agrees not to sue the Sickle Cell Foundation of Georgia, Inc. or its officers, directors, employees, sub-contractors, sponsors, agents and affiliates from all present and future claims that may be made by me, my family, estate, heirs, or assigns for property damage, personal injury or wrongful death arising as a result of my participation in the Volunteer Activities wherever, whenever, or however the same may occur.
I understand and agree that the Sickle Cell Foundation of Georgia, Inc is not responsible for any injury or property damage arising out of the Volunteer Activities, even if caused by their ordinary negligence or otherwise. I understand that participation in the Volunteer Activities involves certain risks, including, but not limited to, serious injury and death. I am participating in the Volunteer Activities with knowledge of the danger involved and I agree to accept all ricks of participation. I also agree to indemnify and hold harmless the Sickle Cell Foundation of Georgia, Inc. for all claims arising out of my participation in the Volunteer Activities. I understand that this document is intended to be as broad and inclusive as permitted by the laws of the state in which the Volunteer Activities take place and agree that if any portion of this Agreement is invalid, the remainder will continue in full legal force and effect. I also acknowledge that the Sickle Cell Foundation of Georgia, Inc. have not arranged and do not carry and insurance of any kind for my benefit or that of Volunteer (if volunteer is under 18), my parents, guardians, trustees, heirs, executors, administrators, successors and assigns.

I represent that, to my knowledge, I am in good health and suffer no physical impairment that would or should prevent my participation in Volunteer Activities. I also understand that this document is a contract which grants certain rights to and eliminates the liability of the Sickle Cell Foundation of Georgia, Inc.

(Signature of Volunteer: _____________________________________________
Date: _________________________________________

I am of legal age and freely signing this agreement. I have read this form and understand that by signing this form, I am giving up legal rights and remedies.
(Signature of Parent/Legal Guardian if Volunteer is Under 18): _____________________________________
Date: ________________________________________

I am the parent of legal guardian of the Volunteer. I am of legal age and am freely signing this agreement. I have read this form and understand that by signing this form. I am giving up legal rights and remedies:
PUBLICITY RELEASE
In return for being allowed to participate in Sickle Cell Foundation of Georgia, Inc. volunteer activities and all related activities, including any activities incidental to such participation (“Volunteer Activities”), the undersigned Volunteer or Parent/Legal Guardian of Volunteer if Volunteer is under the age 18 (hereafter referred to using “I”, “me”, or “my”) hereby grants to Sickle Cell Foundation of Georgia, Inc., and each of its subsidiaries, affiliates, agents, advertising or promotional agencies, and partners, and all "such entities’ officers, directors, agents, employees, respective successors and assigns (collectively, “Authorized Parties”) the absolute and irrevocable right and permission to use, publish, broadcast and/or copyright the use of Volunteer’s name, address, voice, photograph and/or likeness, caricature and personal information, in its current form or as retouched, digitized, cropped, altered, distorted or modified in any way, and all advertising, promotional or other material based upon or derived from the Volunteer Activities in any manner, in any media whatsoever for any and all purposes, including by way of example but without limitation advertising, promoting or publicizing products and services throughout the universe, in perpetuity, in any and all media not known or hereafter devised (including without limitation on the internet), without additional compensation.
I further agree that anything derived there from will be owned solely by the Authorized Parties. I shall not authorize the use of any print, negative or other copy thereof by anyone other than the Authorized Parties. I understand that this document is intended to be as broad and inclusive as permitted by the laws of the state in which the Volunteer Activities that place and agree that if any portion of this Agreement is invalid, the remainder will continue in full legal force and effect.
(Signature of Volunteer): _____________________________________ Date: _______________________
I am of legal age and am freely signing this agreement. I have read this form and understand that by signing this form, I am giving up legal rights and remedies.
(Signature of Parent/Legal Guardian if Volunteer is Under 18): _____________________________________
Date: ________________________________________
I am the parent of legal guardian of the Volunteer. I am of legal age and am freely signing this agreement. I have read this form and understand that by signing this form. I am giving up legal rights and remedies: