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Volunteer Intake Form

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Introduction to Abundant Life:

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Thank you for your desire to work with Charlottesville Abundant Life Ministries! Partnering with the Prospect neighborhood is a mutually transformative experience that we are excited for you to join. This information sheet helps us get to know you a little better as we find a place within our team for you to use your skills well. If you already have a program you would like to be involved with, there is a place for you to mark that as well.
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For our youth programs, priority is given to those who can commit to two consecutive years of volunteering.
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Every volunteer is also required to fill out and have notarized a CPS Background check in compliance with Abundant Life policy. More information from the Volunteer Coordinator will be emailed within a week of submission of this intake form.
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NOTE ABOUT SIGNING THE FOLLOWING FORMS:
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When you type your name on the signature lines of the following pages, you understand and agree that doing so has the same legal force and effect as signing physically with a pen. (If you prefer to sign physically, you may submit these pages without your signature, and then ask us to print each page for you to sign physically).
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Abundant Life Mission Statement:

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Abundant Life demonstrates God’s love through holistic community development in the Prospect neighborhood.
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I have read and am aware of Abundant Life's mission.
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General Information

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If you are a student, please list your school, current year, and expected graduation date.
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In the event of an emergency, whom should we contact? Please provide name, relationship, and phone number.
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. . . . . . POSITIONS OF INTEREST: (below, check all that apply)
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Do you have specific skills/experiences/education that you feel could be helpful when serving with us?
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Do you have any physical handicaps or conditions preventing you from performing certain types of activities (especially in relation to children's or youth work)?
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If yes, please explain:
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Legal:

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Have you ever been charged with a felony or misdemeanor (other than a minor traffic violation)?
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If yes, please explain:
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Have you ever been charged with child abuse or of a crime involving the actual or the attempted molestation of a minor?
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If yes, please explain:
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References

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Please provide three references unrelated to you and who have known you for THREE YEARS or more - teacher, pastor, employer (past/present), co-worker, coach, mentor. If you have prior volunteer experience, please include a reference from that organization. Please include an email address for each one.
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Reference One:

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Name
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Email
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Organization (if applicaple)
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Title
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Phone
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Relationship to Applicant
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Years Known
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Reference Two: 

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Name
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Email
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Organization (if applicable)
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Title
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Phone
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Relationship to Applicant
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Years Known
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Reference Three:

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Name
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Email
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Organization (if applicable)
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Title
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Phone
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Relationship to Applicant
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Years Known
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Applicant's Statement

The information contained in this application is correct to the best of my knowledge, and I authorize Abundant Life Ministries to check my references.  I authorize any references or churches listed in this application to give you any information (including opinions) that they may have regarding my character and fitness for ministry service.  I release all such references from any liability for furnishing such evaluations to you, provided they do so in good faith and without malice.  I waive any right that I may have to inspect references provided on my behalf.

If my application is accepted, I agree to be bound by the Bylaws and policies of Charlottesville Abundant Life Ministries, and to refrain from unscriptural conduct in the performance of my services on behalf of the ministry.

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Respiratory Viruses/Covid-19 Liability Waiver Form

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I acknowledge the contagious nature of Respiratory Viruses like the Flu, RSV, and COVID-19 and that the Centers for Disease Control and Prevention (CDC) updates its guidelines from time to time. Current CDC information can be found by clicking here:
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CDC Virus Info

(https://www.cdc.gov/media/releases/2024/p0301-respiratory-virus.html)

 

"The recommendations suggest returning to normal activities when, for at least 24 hours, symptoms are improving overall, and if a fever was present, it has been gone without use of a fever-reducing medication."

 

 

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I acknowledge that Abundant Life Ministries cannot guarantee that I will not become infected with respiratory viruses from participating in Abundant Life programs.
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I hereby release and agree to hold Abundant Life Ministries harmless from, and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself and/or property that may be caused by any act, or failure to act of Abundant Life Ministries, or that may otherwise arise in any way in connection with any services received from Abundant Life Ministries. I understand that this release discharges Abundant Life Ministries from any liability or claim that I, my heirs, or any personal representatives may have against the ministry with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise from, or in connection to, any services received from Abundant Life Ministries. This liability waiver and release extends to the ministry together with all owners, partners, and employees.
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Volunteer's Waiver Statement

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Part of our mission is to encourage mutually transformative relationships between volunteers and participants.  Many friendships form when volunteers participate in official, sponsored programs.  To protect both volunteers and program participants, we pay for liability insurance that covers our official programs and events. 

 

However, this insurance protection is only in effect during official, sponsored Abundant Life activities.

 

We are not responsible for unofficial activities that a volunteer and participant chose to participate in outside of Abundant Life programming. Unofficial activities are not required of you and we ask you to use your discretion whether to participate.

 

 

Official, sponsored activities are activities that occur as part of a regular programming held on site or as part of an official sponsored field trip.

Examples: Tutoring at Buford; a 5-8 Club field trip to "Air"; Christmas Store with the tutoring program

 

Un-official, un-sponsored activities are activities not sponsored by Abundant Life and not advertised as being Abundant Life’s activities. Abundant Life does not assume liability or responsibility for unofficial activities. These are activities initiated by individuals acting on their own.

Example: A tutor taking their tutee out for ice cream to celebrate a good grade; A Royal Girls leader taking a few girls to dinner

 

Un-official Activity Suggestions:

1. Communicate clearly with parents/guardians to gain permission and relay details such as what you will be doing, where, and when you will be back. Do NOT rely on children to be messengers. They may forget to tell the parent, pretend they did so, or miscommunicate something. TALK DIRECTLY TO THE PARENT through call or text. You should give the parent your name and phone number, and tell them what time you will return.

 

2. Use your discernment regarding what kinds of activities you do and with whom who you do them. Make sure the activity is safe, age appropriate, and approved by the parent.

 

3. Do not have one-on-ones with volunteers and participants of the opposite gender. Small co-ed groups are allowed as long as there is a female and male volunteer present.

 

4. In general, small group activities are probably safer (more than one child and more than one adult). Children/teens usually feel more comfortable and adults have a helper in case of an emergency.

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Waiver Statement Signature

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I, (volunteer’s name), have read Charlottesville Abundant Life Ministries' Volunteer Waiver Statement and I understand the difference between official, sponsored activities and unofficial, unsponsored activities. I further understand that Abundant Life is not liable for unofficial, unsponsored activities, if I choose to engage in such activities. I understand that I am free to choose not to participate in unofficial, unsponsored activities. If I do participate in unofficial unsponsored activities, I understand that I will be doing so at my own risk. I agree to release and hold harmless Charlottesville Abundant Life Ministries for any and all claims that may arise from any unofficial, unsponsored activities in which I may choose to participate.
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(Note: If you are UNDER THE AGE OF 18:  please print this page (print screen), sign your name, and have your parent sign as well. BUT make sure to hit SUBMIT at the bottom before exiting so your form can be processed. Then mail the form to us at: Abundant Life PO Box 71 Charlottesville, VA 22901)
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Extra Section ONLY For Volunteers Who Are Under Age 18:

 

If I am a volunteer who is under the age of 18, my parent, _____________________, also has read Charlottesville Abundant Life Ministries' Volunteer Waiver Statement and is signing below to indicate that he/she agrees to release and hold harmless Charlottesville Abundant Life Ministries for any and all claims that may arise from any unofficial, unsponsored activities in which I participate. 

 

Parent’s Full Name: ________________________     Parent’s Email: _________________________

 

Parent’s Cell Phone #:______________________

 

Parent’s Signature: ________________________      Date Signed: ____________

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