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For individuals volunteering as part of a group.
Please leave this field empty.
Full Name *
Email Address *
I am affiliated with * (school, program, company)
Group Leader Name
Client's Address/Place of Service (if known)
I certify that I do not have a history of violent crime within the last 5 years. I acknowledge the potential risk involved in volunteering and will not hold Eras Senior Network liable in the event of an accident. I agree to have my photo taken during the service opportunity. I recognize that I am expected to adhere to relevant COVID-19 precautions including wearing a mask, social distancing when possible, and sanitizing any spaces clients may touch. If volunteer is under 18, I certify that I am a legal guardian/parent signing on behalf of a youth volunteer. I understand that I am serving a vulnerable population and will make every effort to respect their dignity, privacy, and interact with integrity.
Type Your Name for Signature *
Today's Date *