Please read the following carefully before signing below and
submitting your application. If the volunteer is under 18 years of age, all
references to “I” “me” “the volunteer” or any similar phrase shall refer to
such volunteer’s parent or legal guardian, on their own behalf and on behalf of
the volunteer, as the context may require).
I desire to work as a volunteer for ICAN and
engage in the activities related to being a volunteer (the “Activities”). I understand
the Activities may include socializing and working with an ICAN dog directly or
indirectly, working in the ICAN office(s), entering and volunteering within
Indiana Department of Corrections facilities, working at special events,
driving dogs in training and consuming food provided for volunteers of ICAN. In
exchange for being allowed to participate in the Activities as a volunteer and
for other good and valuable consideration, the receipt and sufficiency of which
I acknowledge, I hereby freely, voluntarily, and without duress to submit this
application and agree and acknowledge, in doing so and by signing, to the
following terms, conditions, policies and procedures, including the releases
set forth herein:
1. Application. I understand that this is an application
for and not a commitment or promise made by ICAN to participate in a volunteer
opportunity. I have and will continue to provide information throughout the
process that is true, correct, and complete to the best of my knowledge and I
have not and will not withhold any information that would unfavorably affect my
application for a volunteer position. I understand that information contained
on my application may be verified by ICAN and that misrepresentations or omissions
may be cause for my immediate rejection as an applicant for a volunteer
position with ICAN or my termination as a volunteer. I am also aware that ICAN may
review my publicly available social media information, such as posts and other
content uploaded on the Internet, in connection with its determination pursuant
to this application but in no way whatsoever will social media content (or the
lack thereof) be used against a candidate in a discriminatory manner. I
understand and agree that ICAN does not discriminate during the volunteer
selection process based on race, religion, sexual orientation, gender,
disability, or ethnic background. I understand that ICAN does not, and is under
no obligation to, disclose reasons for non-acceptance of volunteers.
2. Criminal Background Check Authorization. I
understand that this volunteer position requires a background check in
connection with the application and I consent to an investigation that may
include, but not be limited to, criminal felony and misdemeanor convictions and
sex offender registries, each at the county and federal levels of every
jurisdiction where I currently reside or where I have previously resided. I
authorize ICAN to conduct the criminal background check described above or
otherwise consent that I will submit the information as directed to complete
the background check. In connection with this, I also authorize the use of law
enforcement agencies and/or private-third-party background check organizations
in the collection of this information. I am aware that information obtained is
not an absolute bar to volunteering, but that such information will be used in
the volunteer selection process in ICAN’s sole discretion. I am aware that ICAN
may request that I pay for the background check as described herein.
3. Release and Waiver. I do
hereby release and forever discharge and hold harmless ICAN and its successors
and assigns from any and all liability, claims, and demands of whatever kind of
nature, either in law or in equity, which arise or may hereafter arise from my
Activities with ICAN. I understand that this Agreement discharges ICAN from any
liability or claim that the I may have against ICAN with respect to any bodily
injury, personal injury, illness, death, or property damage that may result
from my Activities with ICAN, whether caused by the negligence of ICAN or its
officers, directors, employees, or agents or otherwise. I also understand that
ICAN does not assume any responsibility for, or obligation to, provide
financial assistance or other assistance, including but not limited to medical,
health, or disability insurance in the event of injury or illness. Furthermore,
I understand that transporting animals may be dangerous and that accidents can
happen. I assume all risks associated with transporting ICAN dogs and release
ICAN from any liability for any injury, loss, or damage to my, the ICAN dogs,
or any third party that may occur while transporting the Animals.
4. Indemnification. I agree to indemnify and hold ICAN harmless
for any and all liability, losses, damages, judgments, or expenses, including
attorney's fees, that it may incur or sustain arising out of my participation
in the Activities.
5. Medical Treatment. I hereby
give consent and authority to ICAN to obtain medical treatment on my behalf if
I am injured or require medical attention during my participation in the
Activities. I understand and agree that I am solely responsible for all costs
related to such medical treatment, medical transportation, and/or evacuation. I
do hereby release and forever discharge ICAN from any claim whatsoever which
arises or may hereafter arise on account of any first aid, treatment, or
service rendered in connection with the Activities with ICAN.
6. Transportation of Dogs. I agree
to transport an ICAN dog only if I have automobile insurance in effect while
transporting the dog. Upon ICAN’s request, I agree to provide a copy of my
automobile insurance policy. I agree to notify the organization immediately if
my insurance coverage lapses or is cancelled. I assume all liability and risk
associated with transporting dogs and agree to indemnify and hold harmless ICAN
from any and all claims, damages, losses, and expenses arising out of or
related to the transportation of dogs, including but not limited to any injury
or damage caused by a dog during transportation.
7. Assumption of the Risk. I
understand that the Activities may include work that can be hazardous to me,
including, but not limited to, working with an ICAN dog and entering and
volunteering within Indiana Department of Corrections facilities, volunteering
at special events, driving dogs to/from locations, and consuming food provided
for volunteers of ICAN. I voluntarily assume the risk of all such hazards,
whether or not specifically mentioned. Furthermore, I hereby expressly and
specifically assume the risk of injury or harm in these Activities and release
ICAN from all liability for injury, illness, death or property damage resulting
from the Activities of my participation with ICAN.
8. Insurance. I understand that, except as
otherwise agreed to by ICAN in writing, ICAN is not obligated to and does not
carry or maintain health, medical, or disability insurance coverage for me or
any other volunteer. I am expected and encouraged to volunteer with medical or
health insurance coverage in effect.
9. Photographic Release. I do
hereby grant and convey unto ICAN all right, title and interest in any and all
photographic images and video or audio recordings made by ICAN during my
Activities with ICAN, including, but not limited to, any royalties, proceeds,
or other benefits derived from such photographs or recordings.
10. Confidentiality. I
understand that as part of my participation in ICAN Activities I will be
exposed to certain confidential information of ICAN (“Confidential
Information”). I agree that in support of ICAN’s mission, and as part of my
participation in any Activities, I will need to keep confidential certain
information about ICAN and the Activities. I agree to use Confidential
Information (as defined in this Section 8) solely in connection with my service
to ICAN and will not disclose or permit access to Confidential Information
other than to ICAN representatives who need to know such Confidential
Information for valid purposes, or unless given express permission by ICAN’s
president or chairman of the board to disclose Confidential Information to a
third party. For the purposes of this Agreement, “Confidential Information” is
defined as any and all ICAN training and programming methods, financial
information, strategic, business, marketing, fundraising, and financial plans,
names and/or any information that could lead to the disclosure of the identity
of any program participants (volunteers, handlers, donors), program data,
materials, products, technology, computer programs, specifications, manuals, or
other information disclosed or submitted orally, in writing, or by other media
to me by ICAN. I further agree that if am required by law to disclose
Confidential Information, I will promptly notify ICAN prior to the disclosure
of such information. I agree that my obligations under this Section 8 regarding
Confidential Information remain in effect until three (3) years after I cease
my affiliation with ICAN.
11. Communication with Inmate Handlers.
Participation in Activities may take place at any ICAN facility or third-party
location, including, but not limited to, correctional facilities (individuals
at such correctional facilities, “Inmate Handlers”). I agree that during
participation in any Activities at a correctional facility, conversations with
Inmate Handlers will relate only to the training of the ICAN Dog, including,
but not limited to, locations where the dog will travel, home environment set
up, and potential situations the dog will encounter. I agree that any
conversation with Inmate Handlers will not include the exchange of any personal
information including, but not limited to, phone numbers, physical address,
electronic address, or any personal family matters. I agree to have no physical
contact with Inmate Handlers. Hugging, handshakes, high-fives, or any other
form of physical touching is prohibited. Inmate Handlers are not allowed to
receive gifts of any kind. Upon completion of my volunteer work with ICAN, I
understand that I must have no additional communication with the Inmate
Handlers, their family members, or any inmate, including but not limited to,
the following modes of communication: phone calls, mail, email or other electronic
social media. I further understand that any follow up communication with Inmate
Handlers can only occur during ICAN refresher classes, and that the discussions
during such classes can only relate to the training of an ICAN Dog. If the
Inmate Handler is still incarcerated at any correctional facility, but no
longer a part of ICAN, I agree to refrain from making contact of any kind with
that individual. All training questions will be directed to ICAN’s Director of
Client Success. Violation of this Section 9 may result in my dismissal as a
volunteer with ICAN, at ICAN’s sole discretion.
12. Return of ICAN Property. I agree
to return to ICAN all ICAN materials in my possession, including but not
limited to, service dog vests/gear, dog food, crates, marketing materials, or
identification badge. I must return ICAN materials within twenty-four (24)
hours upon request by the President or Chairman of the Board, or within
forty-eight (48) hours after I provide ICAN notice that I will no longer be
serving as an ICAN volunteer.
13. Other. I expressly agree that the
releases under this Agreement are intended to be as broad and inclusive as
permitted by the laws of the State of Indiana, and that this Agreement shall be
governed by and interpreted in accordance with the laws of the State of
Indiana. I agree that in the event that any clause or provision of this
Agreement shall be held to be invalid by any court of competent jurisdiction,
the invalidity of such clause or provision shall not otherwise affect the
remaining provisions of this Agreement which shall continue to be enforceable.
14. Counterparts. This Agreement may be executed in multiple counterparts (including by means of facsimile, electronically transmitted portable document format (PDF) signature pages, or DocuSign), any one of which need not contain the signatures of more than one Party, but all such counterparts taken together will constitute one and the same instrument and will have the same force and effect as an original fully executed version of this Agreement.
ACKNOWLEDGMENT
AND SIGANTURE:
BY SUBMITTING
THIS APPLICATION AND SIGNING BELOW, I ACKNOWLEDGE THAT I HAVE READ AND
UNDERSTOOD ALL OF THE TERMS OF THESE TERMS, CONDITIONS, POLICIES AND PROCEDURES
AND THAT I AM VOLUNTARILY GIVING UP SUBSTANTIAL LEGAL RIGHTS. I UNDERSTAND THAT
I MAY BE PERIODICIALLY ASKED TO RE-SIGN AND ACKNOWLEDGE THESE TERMS,
CONDITIONS, POLICIESA ND PROCEDURES AND THAT MY CONTUINED ABILITY TO VOLUNTEER
MAY RELY ON THE TRUTHFUL COMPLETION OF THE SAME.