VOLUNTEER CONFIDENTIALITY AGREEMENT
Thank you for volunteering with West Valley Community Services. We are delighted by your desire to join
our efforts to ensure that every child and adult is free from poverty. With more than 6,000 people WVCS serves in the West Valley, the task is enormous, and your time with us makes a difference to the community members we serve.
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In consideration of the opportunity afforded me to participate as a volunteer for West Valley Community Services,
By completing the registration form I agree as follows:
1. Voluntary Participation. I acknowledge that I have voluntarily applied to be a volunteer for West Valley
Community Services. I understand that as a volunteer, I will not be paid for my services, and that I will not be
covered by or eligible for any West Valley Community Services insurance, health care, worker’s compensation, or other benefits. I understand that my participation with West Valley Community Services may be terminated at any time by West Valley Community Services or by me.
2. Volunteer Policy. I acknowledge that I have received a copy of the West Valley Community Services
Volunteer Handbook. I understand that I am responsible for knowing and complying with the policies set forth in the Volunteer Handbook during my association with West Valley Community Services.
3. Confidential Information. I understand that during my participation as a volunteer for West Valley
Community Services, I may have access to sensitive or confidential information. This confidential information
may include, but is not limited to: identity, address, contact information, race, disability status, and income
information relating to recipients of West Valley Community Services. I understand that taking notes, copying
records, or removing records is specifically prohibited. At all times during and after my participation, I will
hold in confidence and will not disclose or use any such confidential information regarding other volunteers,
donors, and those whom we serve, except as may be required by my duties as a volunteer for West Valley
Community Services, or as expressly authorized in writing by the Executive Director of West Valley Community Services.
4. Assumption of Risk. I am aware that, in participating as a volunteer, I may be exposed to personal injury or
death or damage to my property or equipment as a result of my activities, the activities of recipients of West
Valley Community Services, employees, other volunteers, the materials or equipment used, or the conditions
under which my volunteer services are performed. I understand that my own safety is my own personal
responsibility, and that I am free at any time to refuse, and should refuse, to do anything with West Valley
Community Services that I believe poses a hazard to me or anyone else, or to my property or anyone else’s.
With knowledge of these risks, I agree to accept any and all risks of personal injury or death or damage to my property.
5. Release of Liability. I agree that I, my successors, assignees, heirs, insurers, agents, guardians, and legal
representatives waive and release any rights, actions, or causes of action against West Valley Community
Services, its officers, directors, and employees, the suppliers of any materials uses, and any of West Valley
Community Services volunteers, or recipients of West Valley Community Services, ( collectively, the “released
Parties”) for injury, death, loss of use, damages arising out of or resulting for the acts or omissions of any
person or entity or my activities as a volunteer. This includes, without limitation, negligence of any of the
Released Parties, whether active or passive, sole or comparative, or other negligence, however caused, arising from or relating to West Valley Community Services or my participation with West Valley Community Services in any way. I understand that West Valley Community Services would not allow me to participate as a volunteer without my agreeing to this waiver and release and the other terms of this agreement.
6. Medical Release. I release and forever discharge the Release Parties from any claim whatsoever arising or
that may arise on account of any first aid, treatment, or medical service, including the lack of such or timing of such, rendered in connection with my participation as a volunteer.
7. Media Authorization. I consent to the unrestricted use by West Valley Community Services, or any person
authorized by West Valley Community Services, in any medium, including the Internet, of any photographs,
recordings, interviews, videotapes, film, or similar visual or auditory recordings of me created in connection
with my participation as a volunteer.
8. My Information. I understand that West Valley Community Services will keep confidential and will not
disclose or use for its benefit, other than in connection with the programs and services that West Valley
Community Services provides, information that I provide to West Valley Community Services, except to the
extent that such information is required to be disclosed by law.
9. Return of Property. At the end of my participation as a volunteer, or upon West Valley Community Services’
request at any other time, I will deliver to West Valley Community Services all of West Valley Community
Services’ property, equipment, and documents, together with all copies, regardless of whether such property contains confidential information.
10. Severability, Survival, and Waiver. If any provision in this Agreement is held invalid or unenforceable, the
other provisions will remain enforceable, and the invalid or unenforceable provision will be considered
modified so that it is valid and enforceable to the maximum extent permitted by law. I understand that this
agreement will survive the termination of my participation and the assignment of this Agreement by West
Valley Community Services to any successor or other assignee and will be binding upon my heirs and legal
representatives.
11. Background Check. I understand that the information contained on my application will be verified by West
Valley Community Services and I hereby give permission for West Valley Community Services to contact
anyone it deems necessary to investigate or verify any information provided by me to discuss my suitability for a volunteer position. I voluntarily and knowingly waive all rights to bring an action for defamation, invasion of privacy, or similar cause of action against anyone providing such information. I understand that
misrepresentations or omissions may be cause for my immediate rejection as an applicant for a volunteer
position with West Valley Community Services or my termination as a volunteer.
12. Health Screening. I understand that West Valley Community Services has to comply with
government health and safety standards. I agree to uphold these standards and will undergo any necessary
health screening, such as a tuberculosis test, when asked to.
THANK YOU FOR VOLUNTEERING WITH WEST VALLEY COMMUNITY SERVICES!
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Contacting Us:
If there are any questions regarding this Volunteer Release and Confidential Information Agreement you may contact us using the information below.
West Valley Community Services
10104 Vista Drive
Cupertino, CA 95014
United States
http://www.wvcommunityservices.org
Last Edited on 1/31/2018