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Home
About
Our Staff
Board of Directors
Contact
Kansas City RSVP
KC Staff
Enroll as a Volunteer
Submit Volunteer Hours
FHVC P.A.C.T.
About P.A.C.T.
FHVC P.A.C.T. Task Force
FHVC P.A.C.T. Ambassador Program
P.A.C.T. Training Request
Programs
Volunteer Opportunities
Connecting Students to Communities
Neighbor 2 Neighbor
Medical Transportation
Volunteer
Request Volunteers
Become a Volunteer
Volunteer Enrollment
Student Volunteer Enrollment (Under 18 only)
Group Volunteer Enrollment
Submit Volunteer Hours
Submit Volunteer Hours for Individuals
Submit Group Volunteer Hours
Events
Festival of Trees
9/11 Day of Remembrance
Sweetheart Dance
Donate
Sign Up to Volunteer with Neighbors Helping Neighbors
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Volunteer Information
This enrollment is only if you are interested in helping with the Neighbor 2 Neighbor program.
Name
*
First
Middle Initial
Last
Address
*
Please list local addresses only.
Street Address
ZIP Code
Phone
*
Email
*
Birth Date
*
MM slash DD slash YYYY
If you are a minor, a parent or legal guardian must complete this online form.
Emergency Contact
Emergency Contact
*
First
Last
Relationship (spouse, child, etc.)
*
Phone
*
Statistical/Demographic Information
What gender do you identify with?
*
Male
Female
Non-binary/ third gender
Prefer not to say
Which ethnic group do you identify with? (Optional)
*
Caucasian
African-American
Pacific Islander
Hispanic
Asian
Native American/Alaskan Native
Are you a veteran or veteran family member?
Veteran
Veteran Family Member
Not a veteran or veteran family member
Are you a student?
*
Yes
No
Do you have a disability?
*
Yes
No
If so, please let us know how we can accommodate or support your performance as a volunteer.
Criminal History
Have you ever been convicted of a crime other than a minor traffic citation?
*
Yes
No
If yes, provide the date and disposition.
A felony conviction will automatically bar you from becoming a volunteer.
Accessibility
Do you have a valid driver's license?
*
Yes
No
Do you have access to a vehicle?
*
Access to a vehicle is not necessary. This information will help us for matching purposes.
Yes
No
What services are you willing/able to help with?
*
Select All
Lawn Mowing
Basic Gardening
Leaf Raking
Snow Shoveling
Do you have access to equipment that may be needed?
*
Lawn mowers or rakes may be provided by the resident.
Select All
Lawn Mower
Rake
Snow Shovel
I do not have access to any equipment.
What does your availability look like?
*
Open at any time
After 5 p.m. on weekdays
Weekends
Other
If other, please specify.
Liability Waiver
All volunteers must read the liability waiver provided below and agree to its terms prior to participation.
By checking this box, I am acknowledging that I have read and agree to all the terms of the Neighbor 2 Neighbor Program liability waiver.
*
I agree.
I, the undersigned, being a volunteer in the Neighbor 2 Neighbor Program (hereinafter "the Program"), or being the parent or legal guardian of such a volunteer in the Program, in consideration for my or another's participation in the Program hereby, for myself and any volunteer for whom I am a parent or legal guardian, release, discharge, and hold harmless the Flint Hills Volunteer Center, and their employees from any and all actions, causes of action, claims or any liabilities whatsoever, known or unknown, now existing or which may arise in the future on account of or in any way related to or arising our of my participation in the Program.
I further state that I am aware of and understand the inherent risks, hazards and dangers associated with the projects I am volunteering for, including threats to life and limb (slipping and falling on snow or ice), being exposed to harsh weather conditions (cold temperatures, extreme heat, and precipitation), and perhaps experiencing complications associated with the weather conditions and physical exertion (fainting, collapse, exhaustion, or other more serious complications). I understand that these are examples of the risks, hazards, and dangers associated with the Neighbors Helping Neighbors Program but not necessarily a complete list.
I further state that my physical health (if I am the volunteer) or the physical health of any volunteer for whom I am a parent or legal guardian, is now and will be during the volunteer's participation in the Program, sufficiently sound to permit such person(s) to safely participate in this Program.
Media Release & Promotional Materials
I give permission for the Flint Hills Volunteer Center to publish the photographs taken of me and my name for use in printed publications and websites. I acknowledge that since my participation in publications and websites is voluntary, I will not receive financial compensation. I further agree that my participation in any publication and website produced confers upon me no rights of ownership whatsoever. I release FHVC, it's contractors, and it's employees from liability for any claims by me or a third party in connection with my participation.
*
I DO authorize the use of my name and picture for this purpose.
I DO NOT authorize the use of my name and picture for this purpose.
Acknowledgement of Enrollment
By enrolling as a volunteer with the Flint Hills Volunteer Center with the Neighbor 2 Neighbor program, I acknowledge:
*
Please check each box to indicate agreement.
Select All
I volunteer my services through the FHVC and understand that I am not employees of the RSVP grant, the sponsor, or the volunteer station of the Federal Government, and agree to serve without compensation. (1)
I understand that the information provided on this form may be disclosed for the purpose of volunteerism only. (2)
I commit to maintain the confidentiality of all proprietary or privileged information to which I are exposed while services as volunteers, whether this information involves staff, volunteers, members, or other persons involved in overall agency business. I understand that violations of confidentiality will result in immediate dismissal from my volunteer assignment. (3)
Volunteer Signature
By typing your name and dating, you are verifying that all information provided is accurate and truthful.
*
First
Last
Date
*
MM slash DD slash YYYY
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