Volunteer Intake Form

References

Please list three local, non-family members. Positive reference responses are required prior to volunteering at Teton Literacy Center.
Reference 1 *

First Name Last Name
Reference 1 Email *
example@example.com
Phone Number

Area Code Phone Number
Reference 2 *

First Name Last Name
Reference 2 Email *
example@example.com
Phone Number

Area Code Phone Number
Reference 3 *

First Name Last Name
Reference 3 Email *
example@example.com
Phone Number

Area Code Phone Number

Release from Liability
I am aware that as a volunteer I expose myself to potential hazards which include but are not limited to: accidents, illness, property damage, etc. 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 damage 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 Teton Literacy Center and its officers, volunteers and agents from all actions, 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.

I have carefully read this agreement and fully understand its contents. I am aware that this is a release of liability and I sign it of my own free will.
Signature *

Clear
Applicants under the age of 18 need parent/guardian agreement to our liability release. By signing below you agree to adhere to the above Release from Liability for your child.

Clear

Zoom Consent
If I am paired to volunteer virtually with a tutoring student, small group or TLC class, I understand that TLC will supervise Zoom sessions and regularly check-in on me and my student(s), but will not always be present in breakoutrooms during the session. Further, I grant permission for my Zoom sessions to be recorded for TLC legal, safety and training purposes. Finally, I understand that TLC will closely monitor all participants to ensure appropriate behaviors, but is not responsible for the words, actions and virtual backgrounds of students and their families.
Signature *

Clear
Applicants under the age of 18 need parent/guardian agreement to our Zoom Consent. By signing below you agree to adhere to the above Zoom Consent for your child.

Clear

Photography Consent
Please initial if we can use your photo in our marketing materials.

Clear
Applicants under the age of 18 require parent initials to consent to use of their photographs.

Clear

Application Submission
By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions or other misrepresentations made by me on this application may result in my immediate dismissal. *

Clear
Applicants under the age of 18 need parent/guardian permission to volunteer. By signing below you authorize your child to volunteer at Teton Literacy Center.

Clear
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2020/21 Teton Literacy Center Volunteer Application