Volunteer Application

Automobile Insurance Statement

All Meals-on-Wheels volunteers use their own transportation to deliver meals.

If I use my personal automobile in my volunteer service, I understand that I must have a current driver's license and keep automobile liability insurance in effect equal to the minimum limits required by North Carolina. I will inform Meals on Wheels Rowan of any future changes.

Please indicate that you've read and agree to have a current driver's license and automobile liability insurance by checking the box below:

Liability Waiver

By signing this document, I voluntarily waive, release, and hold harmless Meals on Wheels Rowan of any liability due to accident or illness while performing volunteer services. I also agree for myself and for any child/minor volunteer I am responsible for to follow all rules, procedures, and instructions that apply to my role.

If I am allowing a child/minor to participate in the activity, I agree that I am a parent, legal guardian, or am otherwise responsible for the child/minor who is participating, and I release, waive, and discharge any legal rights that I may assert on behalf of them volunteering. Furthermore, I understand that Meals on Wheels Rowan provides no compensation, insurance, or worker's compensation coverage for my child or me.

Please indicate that you've read and agree to this statement by checking the box below:

Confidentiality Statement

The confidentiality of program participants is very important to us. Please read the below statement carefully:

Meals on Wheels Rowan respects the privacy of all program participants. All volunteers are expected to maintain the confidentiality and the privacy of each participant, both past and present. Information regarding any program participant shall not be disclosed in a form that identifies the participant to any other person or agency. Volunteers will refrain from discussing participants with anyone except appropriate Meals on Wheels Rowan staff.

Please indicate that you've read and agree to this statement by checking the box below:

Conflict of Interest Statement

Meals on Wheels Rowan asks you as a volunteer to:

• Avoid activity construed as a conflict of interest, i.e., neither accept loans or gifts of money or property from clients nor give gifts of money or property to clients, unless through an organized agency program.
• No solicitation is permitted.
• Refrain from offering medical, legal, or financial advice to clients. Any items of this nature should be referred to the Meals on Wheels Rowan staff.

Please indicate that you've read and agree to this statement by checking the box below:

Photo Release Form

I authorize Meals on Wheels Rowan to use my photograph and name to further their mission of providing a nutritious meal delivered by volunteers who offer a friendly greeting and provide an informal safety check to homebound seniors and disabled citizens of Rowan County.

I understand that my photograph may be used in a wide variety of promotional materials including newsletters, flyers, posters, brochures, advertisements, fundraising letters, annual reports, press kits and submissions to journalists, websites, social networking sites and other print and digital communications.