Volunteer Registration

Title*
Gender*
Do you speak another language other than English?*
Have you previously served as a mentor?*
Are you willing to submit to a background investigation?*
How many hours per week are you available to volunteer?*
What days of the week are you able to volunteer? (multiple selection)*
How did you hear about us? (multiple selection)*

VOLUNTEER RELEASE WAIVER OF LIABILITY

I hereby agree to accept a position as a volunteer for The Black Pearl Foundation. I acknowledge I have read and accept these conditions: Releases The Black Pearl Foundation a non-profit corporation organized and existing under the laws of the State of North Carolina and each of its directors, officers, and agents. The volunteer desires to provide services for The Black Pearl Foundation and engage in activities related to serving as a volunteer by performing associated duties. A Volunteer is defined as, foster parents, Community service workers (Court orders or not), or a Vendor that is participating in on site functions. Volunteers understand that the scope of a volunteers’ relationship with is limited to a volunteer position and The Black Pearl Foundation that no compensation is expected in return for services provided by volunteer. That The Black Pearl Foundation will not provide any benefits traditionally associated with employment to a volunteer; and that the volunteer is responsible for his/her own insurance coverage in the event of personal injury or illness as a result of volunteer services to The Black Pearl Foundation.

(1) Waiver and Release: I, the volunteer, release and forever discharge and hold harmless The Black Pearl Foundation and assigns form any and all liability, claims, demands of whatever kind of nature, either in law or in equity, which arise or may hereafter arise for the services I, the volunteer/contractor, provide to The Black Pearl Foundation. I understand and acknowledge that this Waiver and Release discharges The Black Pearl Foundation from and liability or claims that I may have against The Black Pearl Foundation with respect to bodily injury, illness, death, or property damage that may result from the services that I provide to The Black Pearl Foundation or occurring while I am providing volunteer services.

(2) Insurance: Further, I understand that The Black Pearl Foundation does NOT assume any responsibility for or obligation to provide me, the volunteer, with financial or other assistance, including but not limited to medical health or disability benefits or insurance of any nature in the event of such injury or medical expenses incurred by me.

(3) Medical Treatment: I hereby release and forever discharge The Black Pearl Foundation from any claim whatsoever which may arise or may hereafter arise on account of any first-aid treatment or other medical services rendered in connection with any emergency during my tenure as a volunteer with The Black Pearl Foundation.

(4) Assumption and Risk I understand that my time with The Black Pearl Foundation may include activities that may be hazardous to me, including, but not limited to, responsibilities in outside activities, heavy lifting, running, and other physical activities. I further understand that there is a risk of exposure to COVID-19 with my presence and/or interaction with others at The Black Pearl Foundation. I hereby expressly and specifically assume the risk of injury, illness or harm in these activities and release The Black Pearl Foundation from all liability for injury, illness, death, or property damage resulting from the activities of my time with The Black Pearl Foundation. I hereby expressly assume the risk of injury or harm from these activities and release The Black Pearl Foundation from all liability for injury, illness, death or property damage resulting from the services that I provide as a volunteer or occurring while I am providing volunteer services at The Black Pearl Foundation.

(5) Photographic Release: I grant and convey to The Black Pearl Foundation all the right, title, and interests in any and all photographs, images, video, or audio recordings of me or my likeness or voice made by The Black Pearl Foundation in connections with my providing volunteer services to The Black Pearl Foundation.

(6) Dress Code and Professionalism: As a volunteer with The Black Pearl Foundation, you are a representative of the organization and personal cleanliness, and good grooming are essential. Your personal appearance and dress should be clean, neat and professional at all times. The Black Pearl Foundation T-Shirts are encouraged for volunteers. Your conduct should also be professional. Foul language and rowdiness will NOT be tolerated. As well, good customer service is expected of you if you are speaking to potential volunteers and youth.

(7) Other: As a volunteer, I expressly agree that this Waiver and Release is intended to be as broad and inclusive as permitted by the laws of the state of North Carolina and that this Release shall be governed by and interpreted in accordance with the laws of the state of North Carolina. I agree that in the event that any clause or provision of this Waiver and Release is deemed invalid, the enforceability of the remaining provisions of this release shall not be affected. Please read and confirm by submitting this application *

a. I confirm that I have not been named as a perpetrator of a founded report of child abuse/maltreatment nor am I currently under investigation or been convicted of a crime involving a child or a violent crime of any kind anywhere in the United States or its territories or possessions the State of North Carolina or a foreign nation.

b. I understand that if I willfully fail to disclose any criminal background information, it will result in immediate denial of my application and complete revocation of my volunteer ability with the Partnership. I fully understand that the Partnership for The Black Pearl Foundation will immediately turnover any failure to disclose and/or violation of the law to authorities.

c. I will ensure confidentiality and privacy for the people we serve. I will not disclose any information about a person to anyone outside of this organization. Disclosure can be made only under specified conditions for reasons relating to law enforcement or fulfillment of the mission and on a need-to-know basis.

d. I agree to not take any photos or videos of clients being served or their children, nor will I share any images or videos on social media of clients or their children. I will not speak to any members of the media without the permission of the officer or Chair of Board on duty.

e. I give permission to the Partnership for The Black Pearl Foundation and other news media entities, to prepare, reproduce, publish, or exhibit my or my child’s picture, portrait, or likeness for use by the news media or the Partnership in their news and public awareness programs. Any photograph, photo transparency, drawing, or other illustrative graphic material, audio‐visual tape, or audio‐visual illustrations, news report, story, or article may be used without my prior examination of the finished product.

f. I hereby waive my (or my minor child’s right) to privacy in connection with consent below given and hereby release, discharge, and agree to hold harmless all the parties to whom this consent is given from any liability whatsoever and agree that this consent and waiver will not be made the basis of a future claim of any kind.

g. I understand that if I willfully fail to follow these guidelines, I may be relieved of my volunteer duties immediately.

h. I confirm that I am at least 18 years of age or a minor who has obtained written permission from my parent or legal guardian.

If under the age of 18 you must have a parent or legal guardian sign this waiver before you may participate in any activities at or for The Black Pearl Foundation.

The Black Pearl Foundation 501(c)(3) - Charlotte, North Carolina

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