Mitzvah Food Program Volunteer Registration Form

in favor of Jewish Federation of Greater Philadelphia (Jewish Federation), a nonprofit corporation, and Jewish Federation’s directors, officers, employees, agents, representatives, successors, and assigns (together with Jewish Federation, the Jewish Federation persons).

The Volunteer(s) desire to serve as a volunteer for Jewish Federation and engage in the activities related to being a volunteer. The Volunteer understands that the Activities may include those related to fundraising phone-a-thons, assisting older persons with certain tasks in their home, cooking meals, picking up litter, participating in missions and trips within the US, transporting goods, planting and gardening, visiting the sick and elderly, packaging donated goods, painting murals, building and repair work, dance-a-thon, etc.

The Volunteer hereby freely, voluntarily, and without duress executes this Release under the following terms:

1. Release and Waiver: Volunteer does hereby release and forever discharge and hold harmless the Jewish Federation persons from any and all liability, charges, causes of action, claims, demands and other matters of any kind or nature, either in law or in equity, which arises or hereafter may arise from or on account of Volunteer’s Activities with Jewish Federation. Volunteer understands that this Release discharges the Jewish Federation persons from any liability, charges, causes of action, claims, demands, and other matters of any kind or nature that the Volunteer may have against the Jewish Federation persons with respect to any and all matters, including but not limited to any bodily injury, personal injury, illness, death, loss, expense, charge or property damage that may result from or in connection with Volunteer’s Activities with Jewish Federation, whether caused by the negligence of the Jewish Federation persons or otherwise. Volunteer also understands that the Jewish Federation persons do not assume responsibility for or any obligation to provide financial assistance or other assistance, including but not limited to medical, health, or disability insurance in the event of injury or illness.

2. Medical Treatment: : Volunteer does hereby release and forever discharge the Jewish Federation persons from any liability, charges, causes of action, claims, demands and other matters of any kind or nature, either in law or in equity, which arises or hereafter may arise from or on account of any first aid, treatment, or service rendered in connection with the Volunteer’s Activities with Jewish Federation.

3. Assumption of the Risk: The Volunteer understands that the Activities include work that may be hazardous to the Volunteer, including, but not limited to those outlined above. Volunteer hereby expressly and specifically assumes the risk of injury or harm in the Activities and releases and forever discharges and holds harmless the Jewish Federation persons from all liability for and of all matters, including but not limited to injury, illness, death, loss, expense, charge or property damage that may result from the Activities.

4. Insurance: The Volunteer understands that, except as otherwise agreed to by Jewish Federation in writing, Jewish Federation does not carry or maintain health, medical, or disability insurance coverage for any Volunteer. Each volunteer is expected and encouraged to obtain his or her own medical and health insurance. If activities include Volunteer using their own automobile, Volunteer understands they are responsible for obtaining auto insurance on their vehicle and that Jewish Federation will not be responsible or liable for any personal injury or property damage caused in whole or in part while Volunteer is using their personal vehicle.

5. Photographic Release: Volunteer does hereby grant and convey unto Jewish Federation all right, title, and interest in any and all photographic images and video or audio recordings made by Jewish Federation during the volunteer’s Activities with Jewish Federation, including, but not limited to, any royalties, proceeds, or other benefits derived from such photographs or recordings.

6. Acknowledgment: Volunteer acknowledges having received and reviewed Jewish Federation’s Child Abuse Reporting policy located on page 3 of this Release.

7. Other: Volunteer expressly agrees that this Release is intended to be as broad and inclusive as permitted by the laws of the Commonwealth of Pennsylvania, and that this Release shall be governed by and interpreted in accordance with the laws of the Commonwealth of Pennsylvania. Volunteer agrees that in the event that any clause or provision of this Release is held to be invalid by any court of competent jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining provisions of this Release, which shall continue to be enforceable.

IN WITNESS WHEREOF, Volunteer and Parent / Legal Guardian have executed this Release as of the day and year first above written.

For all signatures below, please type in your full name.

a minor, do hereby authorize Jewish Federation of Greater Philadelphia its directors, officers, employees, agents and representatives to provide and/or consent to first-aid treatment or other medical services which may become necessary in connection with an emergency during said minor’s participation in any Jewish Federation of Greater Philadelphia activity.

CHILD ABUSE REPORTING

Section 1:
Jewish Federation of Greater Philadelphia is committed to the prevention of child abuse. While employees and volunteers rarely come in contact with children in the course of their activities there are a few occasions when our employees and volunteers work with groups of children. The organization is committed to complying with the legal and ethical requirements for reporting child abuse. For purposes of this policy, child abuse means physical injury, sexual abuse, or emotional abuse inflicted on a child (as defined by Pennsylvania law) other than by accidental means, by those responsible for the child’s care, custody and control or by persons who are agents or employees of the Jewish Federation. All persons hired by the Jewish Federation in any capacity and volunteers are required to acknowledge having received this policy and are expected to comply with the policy and the associated procedures, as well as with applicable state law.

Procedure – Child Abuse Reporting

1. 1. Any observer of child abuse of any kind has the affirmative duty to promptly report the matter directly to the Director of Human Resources. The observer of child abuse also has the option of reporting the incident directly to the State Child Line at 1-800-932-0313.

2. The Director of Human Resources will complete an intake form which records and acknowledges that a report has been filed and will provide the reporter with a copy of the completed form.

3. The Director, as a mandated reporter, will call the State Child Line at 1-800- 932-0313 if the person assaulted is a child. In the event of an active assault, the Director will also call the police.

4. Immediately after notifying the Child Line and/or police, the Director of HR will notify the Chief Financial and Administrative Officer and the Chief Executive Officer and will also notify the initial observer of the abuse of the date/time at which the incident was reported to Child Line.

5. The CEO shall notify the President of the Board of Director’s, who may direct that all Director’s be notified.

6. The CEO will notify the Chief Marketing Officer to prepare for media inquiries if it is deemed appropriate.

7. All parties shall keep a documentary record of the communications and timelines to aid in future investigatory processes.

8. All individuals are directed to cooperate with the related investigation processes of the Jewish Federation, the Children and Youth Services investigators, as well as any police organizations.

9. Groups using the Jewish Community Services Building facilities who will be bringing youth on site shall, as a condition of use, submit both their own policy on reporting child abuse and a certification (warranty + representation in legal terms) that their staff and volunteers who will be on campus have undergone background checks.

Section 2:

Jewish Federation employees who work with individuals under the age of 18 years must comply with the clearance requirements of the Commonwealth of Pennsylvania. This includes completion of an FBI fingerprint clearance, a child abuse history clearance and a Pennsylvania criminal record check. Employees are responsible for keeping a copy of the certificates and for sending the originals to the Human Resources Department.

Section 3:

Jewish Federation volunteers who work with individuals under the age of 18 must provide certificates of their child abuse history clearance and a Pennsylvania criminal record check. These should be kept on file in the department in which the volunteer works.

IF PARTICIPANT(S) IS UNDER 18 – Parent / Legal Guardian must complete section below

Parental Authorization for Treatment of Minor Child: