Volunteer Release

I wish to intern/volunteer for Realm of Caring Foundation. I understand that my consent to these provisions is given in consideration for being permitted to intern/volunteer. I UNDERSTAND THAT THE NATURE OF INTERNSHIP AND VOLUNTEER ACTIVITIES THAT I MAY PERFORM IN MY CAPACITY AS AN INTERN OR VOLUNTEER MAY INVOLVE PHYSICAL ACTIVITY, CONTACT WITH UNIDENTIFIED OR UNFAMILIAR PERSONS, OR OTHER POTENTIAL RISK OF BODILY INJURY OR DAMAGE TO PROPERTY AND I HEREBY VOLUNTARILY ASSUME FULL AND COMPLETE RESPONSIBILITY FOR, AND THE RISK OF, ANY INJURY OR ACCIDENT WHICH MAY OCCUR DURING MY INTERNSHIP OR VOLUNTEER WORK WITH REALM OF CARING. TO THE FULLEST EXTENT OF THE LAW, I, FOR MYSELF, MY NEXT OF KIN, MY HEIRS, ADMINISTRATORS, AND EXECUTORS (COLLECTIVELY, “RELEASORS”), HEREBY RELEASE AND HOLD HARMLESS AND COVENANT NOT TO FILE SUIT AGAINST REALM OF CARING, AND ALL OTHER AFFILIATES OF REALM OF CARING HEADQUARTERS AND THEIR RESPECTIVE DIRECTORS, OFFICERS, INTERNS, VOLUNTEERS, AGENTS AND EMPLOYEES; AND (II) ALL OTHER PERSONS OR ENTITIES ASSOCIATED WITH REALM OF CARING (COLLECTIVELY, THE “RELEASEES”) FOR ANY INJURY OR DAMAGES I MIGHT SUFFER IN CONNECTION WITH MY INTERNSHIP/VOLUNTEER WORK WITH REALM OF CARING. THIS RELEASE APPLIES TO ANY AND ALL LOSS, LIABILITY, OR CLAIMS I OR MY RELEASORS MAY HAVE ARISING OUT OF MY INTERNSHIP/VOLUNTEER WORK WITH REALM OF CARING, INCLUDING BUT NOT LIMITED TO, PERSONAL INJURY OR DAMAGE SUFFERED BY ME OR OTHERS, WHETHER SUCH LOSSES, LIABILITIES, OR CLAIMS BE CAUSED BY CONTACT WITH AND/OR THE ACTIONS OF OTHER PERSONS, CONTACT WITH FIXED OR NONFIXED OBJECTS, NEGLIGENCE OF THE RELEASEES, RISKS NOT KNOWN TO ME OR NOT REASONABLY FORESEEABLE AT THIS TIME, OR OTHERWISE.

I understand that as an intern or volunteer, I may become privy to confidential information. I agree to maintain the confidentiality of any information marked “confidential” as well as any information about business operations, organizational structure, employee information, financial operations, marketing strategy, organization, donor lists and amounts, plans for upcoming events, current or proposed business transactions and sponsorships, and any proprietary information such as computer software and programming and the like that is not otherwise publicly disclosed. I will not use any confidential information in any manner that would be detrimental.

At all times during my internship and volunteer work with Realm of Caring, I will conduct myself in such a manner as not to reflect unfavorably on or in any way diminish the reputation of Realm of Caring. I give my consent and permission to Realm of Caring and its respective affiliates, successors, licensees, and assigns the irrevocable right to use, for any purpose whatsoever and without compensation, any photographs, videotapes, audiotapes, or other recordings of me that are made during the course of interning/volunteering with Realm of Caring.

This Release shall be construed under the laws of the state in which Realm of Caring is located. In the event any provision of this Release is deemed unenforceable by law, (i) the Realm of Caring shall have the right to modify such provision to the extent necessary to be deemed enforceable; and (ii) all other provisions of this Release shall remain in full force and effect.

I understand that I have given up substantial rights by signing this Release, and have signed it freely and voluntarily without any inducement, assurance or guarantee being made to me and intend my signature to be a complete and unconditional release of liability to the greatest extent allowed by law.

Information to Applicants

You may be asked to sign an authorization for Realm of Caring to fully investigate your suitability for an internship or volunteering opportunity (depending on the position and responsibilities) by obtaining information from your previous employers and/or other knowledgeable persons as to their firsthand experiences with you, and also, when deemed necessary, by obtaining reports from credit bureaus, credit agencies, or other consumer reporting agencies. Under some circumstances, certain of such reports may be “consumer reports” or "investigative consumer reports" as to which, under the Fair Credit Reporting Act, you are entitled, upon your request in writing, to receive a complete and accurate disclosure of the nature and scope of the investigation requested by Realm of Caring.

Applicant Statement

I certify that I completed this application and that all the answers to the questions on this application and any attachments are to the best of my knowledge true and correct and that I have not knowingly withheld any pertinent facts or circumstances all of which are subject to validation. I understand that any misrepresentation, false statement, or omission made by me with respect to the information contained in this application could disqualify me from consideration as an intern/volunteer, or if selected as an intern/volunteer, result in my termination from Realm of Caring.

If selected as an intern/volunteer, I agree to comply with the rules and regulations of Realm of Caring.

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Intern & Volunteer Application




Are you applying as an intern or a volunteer?


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Personal Information




Name*

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Email*

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Street Address*

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City*

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State

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ZIP Code*

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Day Telephone

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Evening Telephone

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Preferred Contact Method*


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(Applicants will receive e-mail newsletters from Realm of Caring)


Employer

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Position

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How did you hear about us?*

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Why do you want to intern/volunteer for Realm of Caring?*

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Have you interned/volunteered for us in the past?*


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If you previously interned/volunteered, when was it?

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SKILLS




Please indicate if you have more than one year of experience in the following areas.



















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Are you a nurse, CNA, or do you have a current CPR certification?*


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If you are multilingual and willing to share your skills, please list your fluent languages.

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Please list any additional skills you are willing to contribute.

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How often would you like to contribute?*



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Daytime Availability*


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Evening Availability*


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Weekend Availability*


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I am interested in a*



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If you selected "other," please describe your positional interest.

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Upload your resume here. (optional)

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References and Additional Info





Reference 1




Name*

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Email*

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Phone*

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Relationship to Volunteer*

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Reference 2




Name*

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Email*

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Phone*

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Relationship to Volunteer*

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Reference 3




Name*

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Email*

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Phone*

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Relationship to Volunteer*

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Emergency Contact




Emergency Contact Name*

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Emergency Contact Phone*

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Relationship to Volunteer*

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Have you been convicted (including entering a plea of guilty or nolo contendere) of any felony crimes within the past 7 years? Do not include convictions that were sealed or expunged pursuant to a court order.*


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Have you ever been charged with a crime involving a child?*


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Please provide the date, place of the offense, and charge.

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What other information do you believe is pertinent to our full understanding of this matter?

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*

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