Date: Waiver of Liability for Providing Volunteer Services I,First Name* Last Name*, wishing to volunteer my time and services for Women’s Center of Brevard hereby acknowledge that said organization is doing everything they can to protect the public as well myself as a volunteer. To this extent, I agree to follow Center of Disease Control (CDC) and local health district guidelines and Women’s Center of Brevard policies and procedures for social d istancing to reduce the spread of Novel Coronavirus, or COVID-19. This will require me to maintain six (6) feet of distance between myself , f ellow volunteers, and patrons of t he organization as much as possible. This procedure will be required fo r visitor-to-visitor contact as well to limit exposure. I agree to utilize surgical masks or improvised masks such as scarves, bandanas, and handkerchiefs to reduce the risk of exposure to myself and others. I agree to wash or sanitize my hands after using the restroom, sneezing, and coughing. I understand that I may be informed of or encounter sensitive Personal Health Information (PHI) for those that Women’s Center of Brevard serves. I agree to hold this information in confidence and will not disseminate any PHI except as allowed by law and/or per the policy and procedures of said organization which I am volunteering for. I agree to notify staff if I am experiencing any of the following symptoms; fever, sore-throat, flu-like symptoms, or any other symptoms of an illness OR have traveled to a high-risk are for COVID-19 OR had contact with a person with diagnosed or suspected COVID-19, so that all individual in contact with me at the center can be notified of possible exposure. I will not volunteer for at least 3-4 days after symptoms have subsided and/or follow the CDC guidelines for self-isolation before returning to my volunteer duties upon staff clearance. By signing below, I agree to comply with the written instructions above. Failure to comply with these written instructions or verbal instructions from staff may result in my volunteer privileges being removed and I may be asked to leave the premises.First Name* Last Name* Signature*