First Name
Last Name
Email
Address 1
Address 2
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Texas
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Phone Number
Emergency Contact
Emergency Contact's Cell Phone
ASSUMPTION OF RISK
I acknowledge that participation in DMF programs, events, recreational activities, or volunteer duties may involve inherent risks, including the risk of injury or illness. I understand that DMF does not own, operate, or control the facilities or venues where events may be held.
By participating, I voluntarily assume all risks of injury, illness, harm, or damage of any kind that may occur to me as a result of my participation. I hereby release and hold harmless the Denise Marie Flaherty Memorial Foundation, its Board of Directors, officers, staff, volunteers, venues, and affiliates from any and all liability, claims, or responsibility arising from such participation.
MEDIA RELEASE
I grant permission for DMF to photograph, record, interview, or otherwise capture my likeness, voice, or participation during DMF events or activities. I release DMF and all parties involved from any liability or claims related to such media.
I further authorize DMF to use photos, video, audio recordings, interviews, or printed materials featuring me for promotional, marketing, educational, or informational purposes, including but not limited to websites, brochures, publications, advertisements, public service announcements, and social media platforms.
CONFIDENTIALITY AGREEMENT
I understand that my role with DMF may provide access to confidential information regarding the organization, its clients, donors, staff, volunteers, and operations. I agree to maintain strict confidentiality of all such information during and after my volunteer service.
Confidential information includes, but is not limited to, medical information, personal data, financial records, donor information, operational details, and any non-public organizational matters. I will not disclose such information to any third party without prior written authorization from DMF.
Failure to comply with this confidentiality agreement may result in disciplinary action, including termination of volunteer service.
Previous Volunteer Experience
Please tell us any specific abilities you may have: (languages, special training, skills, etc.)
CONFIRMATION
By checking the box provided and printing my name below, I affirm that the facts set forth in this application 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. I also understand that I may be subject to a background check. It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability.
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