Volunteer Application and Waiver

We appreciate your support and your willingness to volunteer and further the mission of Habitat Choptank. Please complete the Volunteer Application and Waiver in its entirety. Thank you!

Your Contact Information

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Other Information

Demographic data is requested for aggregate reporting and tracking, as well as for aiding Habitat Choptank in obtaining grants. This information is confidential and used in a non-discriminatory manner.  It is optional to complete this section.


The maximum length for the field Is there other information you'd like to provide? is 5000 characters.

Availability and Interest

Please complete this section to provide information on when you are available to volunteer and in what areas you would like to volunteer.


Volunteer Agreement, Release, Waiver of Liability

PLEASE READ CAREFULLY! THIS IS A LEGAL DOCUMENT THAT AFFECTS YOUR LEGAL RIGHTS! PLEASE PROVIDE YOUR SIGNATURE.

This Release and Waiver of Liability (the “Release”) is executed today by you (the “Volunteer”), in favor of Habitat for Humanity Choptank, Inc., Habitat for Humanity International, Inc. and any other Habitat for Humanity affiliated organization, and their respective directors, officers, trustees, employees, sponsors, donors, volunteers and agents (collectively, the “Released Parties”).

I, the Volunteer, desire to work as a volunteer for one or more of the Released Parties without compensation and engage in the activities related to being a volunteer. I understand that my activities may include but are not limited to the following: working at Habitat for Humanity offices and worksites; working in or for Habitat for Humanity ReStore operations; loading and unloading materials; traveling to and from work sites; consuming food available or provided; assisting in disaster relief areas; constructing, repairing, and rehabilitating residential buildings; other construction- related activities; and other volunteer activities ("Activities").

I the Volunteer, understand that my Activities may include work that may be hazardous to me, including, but not limited to, the following: construction; loading and unloading; travel to and from the work sites; and exposure to lead, asbestos, and mold, which may cause or worsen certain illnesses, especially if I do not wear protective equipment, am exposed for extended periods of time, or have a pre-existing immune system deficiency. I understand that vacant houses built before 1970 may contain lead paint and/or asbestos. Lead paint and asbestos have been shown to cause severe health problems, especially in children under six years of age. Children and women who are pregnant, nursing, or planning to become pregnant should avoid exposure to lead paint and asbestos.

I understand that Habitat for Humanity Choptank screens all applicants on the sex offender registry. By completing this application, I am submitting myself to such an inquiry. In addition, certain volunteer positions will require a criminal background check and I am willing to submit myself to such an inquiry.

I hereby expressly and specifically assume the risk of injury or harm in the Activities and release the Released Parties from all liability for any loss, cost, expense, injury, illness, death or property damage resulting directly or indirectly from the Activities and/or Volunteer negligence.  I, the Volunteer, hereby freely, voluntarily and without duress execute this Release under the following terms:

Release and Waiver. I, the Volunteer, acknowledge and understand that participation in the Activities may involve certain risks, including, but not limited to, personal injury(ies), bodily injury, illness, permanent disability, property damage, loss and/or death (“Risks”). These Risks include, but are not limited to, exposure to and/or infection with COVID-19 and/or other viruses and/or bacterial infection even in ideal conditions, and despite any and all reasonable efforts made to mitigate such Risks. I further acknowledge and agree that, due to the nature of the Activities, social distancing of six feet per person will not always be possible and that my participation in the Activities may result in an elevated risk of contracting COVID-19 and/or other viruses and/or bacterial infection.

In consideration of and in order to be allowed to participate in the Activities, I do hereby release and forever discharge and hold harmless the Released Parties and their successors and assigns from any and all liability, claims, demands, costs and damages of any kind, whether arising from tort, contract or otherwise, which I or my heirs, assigns, next of kin or legal representatives may have or which may hereinafter accrue, arise from, or are in any way related to my Activities with any of the Released Parties, including but not limited to Risks, whether caused wholly or in part by the simple negligence, fault or other misconduct of any of the Released Parties or of other volunteers, other than their intentional or grossly negligent conduct. In addition, the Released Parties shall have the benefit of any future liability protection for businesses as relating to the COVID-19 pandemic passed by any governmental entity to which the Released Parties are subject.

I understand and acknowledge that by signing this Release I knowingly assume the Risks associated with the Activities. I also understand that the Released Parties do not assume any responsibility for or obligation to provide financial assistance or other assistance, including but not limited to medical, health or disability insurance in the event of injury, illness, death or property damage. Regarding any illness or virus, including COVID-19, I, the Volunteer, understand that even if I follow all guidelines for the prevention and handling of any illness or virus, including COVID-19, there is still a risk that Volunteer could contract such virus or illness.


COVID-19

I understand the signs and symptoms of COVID-19 which include but are not limited to:

  • Fever
  • Chills
  • Loss of Smell or Taste
  • Muscle or Body Aches
  • Sore Throat
  • Cough
  • Shortness of Breath
  • Difficulty Breathing
  • Congestion or Runny Nose
  • Nausea or Vomiting
  • Diarrhea
  • Fatigue

I understand the above listed symptoms and affirm that I, as well as all household members, do not currently have, nor have experienced the symptoms listed above WITHIN THE LAST 14 DAYS. Furthermore, I understand that I should not volunteer if I exhibit any of the symptoms in the future.

I affirm that I, as well as all household members, have not been diagnosed with COVID-19 WITHIN THE PAST 30 DAYS.

I affirm that I, as well as all household members, have not knowingly been exposed to anyone diagnosed with COVID-19 WITHIN THE PAST 30 DAYS.

I affirm that I, as well as all household members, have not traveled outside of the country, or to any city considered to be a "hot spot" for COVID-19 infections WITHIN THE PAST 30 DAYS.

In consideration for receiving permission to BE ON PREMISES at any of the Habitat for Humanity Choptank job sites, affiliate office or ReStore location, (hereinafter the “Activity or Activities”), I, on behalf of myself for whom I have the capacity to contract, hereby acknowledge and agree to the following:

  1. I understand the hazards of the novel coronavirus (“COVID-19”) and am familiar with the Centers for Disease Control and Prevention (“CDC”) guidelines regarding COVID-19. I acknowledge and understand that that the circumstances regarding COVID-19 are changing from day to day and that, accordingly, the CDC guidelines are regularly modified and updated and I accept full responsibility for familiarizing myself with the most recent updates.
  2. Notwithstanding the risks associated with COVID-19, which I readily acknowledge, I hereby willingly choose to participate in Activities.
  3. I acknowledge and fully assume the risk of illness or death related to COVID-19 arising from my being on the premises and participating in the Activities and hereby RELEASE, WAIVE, DISCHARGE, AND COVENANT NOT TO SUE Habitat for Humanity Choptank, Inc., their owners, officers, directors, agents, employees and assigns (the “RELEASEES”) from any liability related to COVID-19 which might occur as a result my being on the premises and participating in the Activities.
  4. I shall indemnify, defend and hold harmless the RELEASEES from and against any and all claims, demands, suits, judgments, losses or expenses of any nature whatsoever (including, without limitation, attorneys’ fees, costs and disbursements, whether of in-house or outside counsel and whether or not an action is brought, on appeal or otherwise), arising from or out of, or relating to, directly or indirectly, the infection of COVID-19 or any other illness or injury.
  5. It is my express intent that this Waiver and Hold Harmless Agreement shall bind any assigns and representatives, and shall be deemed as a RELEASE, WAIVER, DISCHARGE, AND COVENANT NOT TO SUE the above-named RELEASEES. This Agreement and the provisions contained herein shall be construed, interpreted and controlled according to the laws of the State of Maryland. 

I HEREBY KNOWINGLY AND VOLUNTARILY WAIVE ANY RIGHT TO A JURY TRIAL OF ANY DISPUTE ARISING IN CONNECTION WITH THIS AGREEMENT. I ACKNOWLEDGE THAT THIS WAIVER WAS EXPRESSLY NEGOTIATED AND IS A MATERIAL INDUCEMENT TO THE PERMISSION GRANTED BY RELEASEES TO BE ON PREMISES AND PARTICIPATE IN THE ACTIVITIES.


Consent to Transportation and Medical Treatment

I consent to the use of first aid treatment and the use of generic and over-the-counter medications and treatments as directed by manufacturer labels, whether administered by the Released Parties or first aid personnel. In an emergency, I understand the Released Parties may try to contact the individual listed below as an emergency contact. If an emergency contact cannot be reached promptly, I hereby authorize the Released Parties to act as an agent for me to consent to any examination, testing, x-rays, medical, dental or surgical treatment for me as advised by a physician, dentist or other health care provider. This includes, but is not limited to, my assessment, evaluation, medical care and treatment, anesthesia, hospitalization, or other health care treatment or procedure as advised by a physician, dentist or other health care provider. I also authorize the Released Parties to arrange for transportation of me as deemed necessary and appropriate in their discretion. I, the Volunteer, do hereby release, forever discharge and hold harmless the Released Parties from any liability, claim, demand, and action whatsoever brought by me or on my behalf which arises or may hereafter arise on account of any transportation, first aid, assessment, care, treatment, response or service rendered in connection with my Activities with any of the Released Parties.

If the Volunteer is less than 18 years of age, the parent(s) having legal custody and/or the legal guardian(s) of the Volunteer also hereby release, forever discharge and hold harmless the Released Parties from any liability, claim, demand and action whatsoever brought by such volunteer or on his/her behalf which arises or may hereafter arise on account of the decision by any representative or agent of the Released Parties to exercise the power to transport, administer first aid, and consent to assessment, examination, x-rays, medical, dental, surgical or other such health care treatment as set forth in the Parental Authorization for Treatment of, and Travel With, a Minor Child.


Insurance

I understand that, except as otherwise agreed to by the Released Parties in writing, the Released Parties are under no obligation to provide, carry or maintain health, medical, travel, disability or other insurance coverage for any Volunteer. Each Volunteer is expected and encouraged to obtain his or her own health, medical, travel, disability or other insurance coverage.

I understand that I am and remain responsible for payment of such hospital, physician, ambulance, dental, medical or other services obtained for me or my child. I agree that the Released Parties do not assume any responsibility for the payment of such fees or expenses which may be incurred. If I have health insurance, I understand my personal health insurance is my primary coverage.


Confidentiality

I agree that in the course of my participation in the Activities, I may have access to personal and/or health care information of other persons. I agree to maintain the confidentiality of such information, to use such information only as necessary to do my job as a volunteer, and to comply with Habitat for applicable policies regarding such information.


Photographic/Recording Release

I hereby grant and convey unto the Released Parties all right, title and interest in any and all photographs and video/audio/electronic recordings of me, including as to my name, image and voice, made by or on behalf of any of the Released Parties during my Activities with the Released Parties, including, but not limited to, the right to use such materials for any purpose and to any royalties, proceeds or other benefits derived from them. I understand that I will not have any ownership interest in or to such photographs, images and/or recordings, I have not been provided or promised any compensation to me, and I hereby waive any rights, privileges or claims based on any right of publicity, privacy, ownership or any other rights arising, relating to or resulting from the photographs, images and/or recordings. I understand and agree that this paragraph also applies to my minor child(ren) who are volunteering.


Habitat for Humanity Volunteer Code of Conduct

Becoming a Habitat volunteer comes with great rewards and responsibilities. Volunteers like you are representatives of Habitat for Humanity and its ministry. When you accept a volunteer role with Habitat for Humanity, you are committing to act in a way that promotes Habitat’s mission, respects the local community, and ensures the safety of all participants. In addition to complying with all laws, regulations and Habitat for Humanity policies, all volunteers are expected to follow the volunteer code of conduct outlined below. 

  1. Promote a respectful community: Treat all volunteers, employees and community members with respect, courtesy, and dignity. This includes avoiding the use of humiliating, demeaning, offensive, or otherwise insensitive language that fails to respect the dignity of the person. Volunteers are also expected to refrain from engaging in intimidation, physical, sexual, and/or emotional violence toward others. Help promote a welcoming, respectful environment by making efforts to understand and honor the local culture and by following all rules and policies set forth by a Habitat program staff member or supervising volunteer.  Use of social media should be governed by the principles of respecting and protecting vulnerable populations while preserving their dignity and privacy. You are discouraged from posting anything on social media that permits beneficiaries from being identified and/or traced. 
  2. Respect the human rights of all people and protect beneficiaries and community members from exploitation and abuse. All Habitat volunteers must model behavior consistent with the Habitat for Humanity International Safeguarding Policy which protects staff, beneficiaries, and community members (especially vulnerable adults and children) from exploitation and abuse. Inappropriate physical or sexual relationships with other volunteers is prohibited. Under no circumstances, may volunteers engage in sexual activity with a child (a person under the age of 18, regardless of the legal age of consent and local laws), any Habitat staff or beneficiaries, or any community members. This includes not procuring commercial sex acts, even where such activities are permitted by local laws.
  3. Prioritize site safety: Safety rules and guidelines on the volunteer site have been created to keep you and others safe as you volunteer and must be followed. Activities that pose a safety risk to yourself or others should be avoided. Report any unsafe working conditions to the onsite supervisor.
  4. Uphold a zero-tolerance policy for alcohol, drugs and weapons: The purchase or possession of drugs or weapons is strictly prohibited on Habitat for Humanity property and volunteer sites. The purchase or possession of alcohol is also strictly prohibited on Habitat for Humanity volunteer sites, even if permitted by local laws or by the laws of the volunteer’s home country.   
  5. Follow the gift giving policy: To avoid potential misunderstandings, embarrassment, injured feelings or jealousy, volunteers are asked not to exchange gifts with Habitat beneficiaries, staff members or community members without consulting Habitat staff. Volunteers may speak with a staff member about appropriate ways to exchange gifts and our staff is happy to suggest gifts that will benefit the entire community.
  6. Protect ministry assets: Use reasonable care to protect all Habitat for Humanity resources. Stealing, misappropriation or diversion of Habitat for Humanity funds, property, or other assets for personal benefit is not permitted, nor is otherwise engaging in fraudulent activity regarding Habitat for Humanity’s assets, operations, or beneficiaries.
  7. Maintain confidentiality: Build trust with other volunteers and Habitat for Humanity by respecting the confidentiality of volunteers, staff, Habitat beneficiaries, and community members. Unless you receive prior written approval from HFHI, you will not disclose confidential HFHI information or confidential information given to you by others.
  8. Speak up!: Habitat for Humanity embraces a “see something, say something” culture. If you become aware of potential misconduct, help reinforce our culture of courage and accountability by sharing your concerns with an appropriate Habitat staff or supervising volunteer. You can also anonymously report potential misconduct by reporting a claim to the confidential Habitat Ethics and Accountability Line.

Volunteer Orientation

I have completed the Volunteer Orientation for Habitat Choptank and have read and agree to the policies included in the Habitat Choptank Volunteer Handbook, including, but not limited to: 

  • CODE OF CONDUCT
  • DISCRIMINATION AND HARASSMENT
  • CONFLICT RESOLUTION
  • PERSONAL HEALTH AND DRUG AND ALCOHOL ABUSE
  • SEXUAL OFFENDER AND CRIMINAL BACKGROUND CHECK 
  • MEDIA RELEASE 

Waiver Signature

I expressly agree that this Release is intended to be as broad and inclusive as permitted by state law. I further agree that in the event any clause or provision of this Release is held invalid by any court of competent jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining clauses or provisions of this Release, which shall continue to be enforceable. Further, a waiver of a right under this Release by a Released Party does not prevent the exercise of any other right.

I have carefully considered my decision, the benefits and risks involved, and hereby give my informed consent to participate in all volunteer Activities. I have read and understand this Release and Waiver of Liability, I acknowledge that any questions of mine have been answered, and I voluntarily agree to the above provisions. It is my intent to bind my heirs, next of kin, assigns and legal representative.

I acknowledge that I have read, understand and agree to be guided by the volunteer Code of Conduct described in this waiver.

I commit to helping safeguarding the rights and dignities of all people I encounter during my volunteer service with Habitat.

I understand that I have a responsibility to report any potential misconduct to an appropriate Habitat staff or through the Habitat Ethics and Accountability Line.

I understand that Habitat has the right to release me from my volunteer position at its discretion. I also understand that I am responsible for any costs that I may incur due to a violation of the Code of Conduct.


The field Signature of Volunteer (type name) is required.
The date field Waiver Signature Date is required.
The date field Volunteer Birthdate is required.

Volunteers Under 18 Years of Age

I understand and acknowledge that children under the age of 16 are not allowed on Habitat for Humanity worksites while construction is in progress. While minors between the ages of 16 and 18 may be allowed to participate in some types of build site activities, solely as outlined by the Released Parties, I understand that using power tools, excavation, demolition, working on rooftops and similar activities are not permitted for anyone under the age of 18. I agree it is my responsibility to communicate these requirements to any of my minor children who will attend and/or participate in the Activities.

If the Volunteer is less than 18 years of age, all parents or guardians must complete the signature section below.  If only one parent or guardian signs these forms on behalf of a Volunteer who is under 18 years of age, then the undersigned parent or guardian of the Volunteer hereby covenants, warrants, represents and agrees that he or she is executing these forms on behalf of, and as an agent for, any other individual who may be a parent or guardian of the Volunteer, that he/she is fully authorized to do so, and that by executing such Release and Parental Authorization, the undersigned is binding himself/herself, the Volunteer, and any other parent or guardian of the Volunteer, and all of their heirs, next of kin, assigns, and legal representatives to such Release and Parental Authorization.

SIGNATURE OF PARENT/GUARDIAN SIGNING ON BEHALF OF THE ABOVE MINOR:

I have carefully considered my decision, the benefits and risks involved and hereby give my informed consent, on behalf of the above listed minor child, for him/her to participate in all Activities as set forth in the above Volunteer Agreement, Release and Waiver of Liability, and such terms are incorporated herein. I have read and understand the above Volunteer Agreement, Release and Waiver of Liability, any questions of mine have been answered, and I voluntarily agree to all such provisions. It is my intent to bind my and the minor Volunteer's heirs, next of kin, assigns, and legal representatives. Furthermore, I understand that the above Volunteer Agreement, Release and Waiver of Liability is made on behalf of my minor child(ren) and/or legal wards and I represent and warrant to Habitat for Humanity International, Inc. or its affiliated organizations that I have the full authority to sign this on behalf of such minor(s).


The maximum length for the field Parent/Guardian Signature (type name) is 500 characters.
The field Parent/Guardian Signature Date must be a date.
The maximum length for the field Parent/Guardian 1 Name is 500 characters.
The maximum length for the field Parent/Guardian 1 Address is 500 characters.
The field Parent/Guardian 1 Phone must be a phone number.
The field Parent/Guardian 1 Email must be an email.
The maximum length for the field Parent/Guardian 2 Name is 500 characters.
The maximum length for the field Parent/Guardian 2 Address is 500 characters.
The field Parent/Guardian 2 Phone must be a phone number.
The field Parent/Guardian 2 Email must be an email.