Volunteer Authorization Form
Thank you very much for volunteering to serve our community. In order to serve at Mission Marshall we ask that you read, review and fill out the information below to proceed.
Mission Marshall (MM) is committed to the safety and welfare of its clients. MM is also committed to the confidentiality
of all information regarding its clients as a means of ensuring their safety.
Confidentiality is defined as the assurance that access to information regarding any client shall be strictly controlled, and that any violation of such control shall be a breach of faith. Confidential information shall include, but is not limited to:
1. Communications, information and observations made by and between or about adult and child clients, staff, volunteers, student interns; and board members;
2. Addresses of employment, residence, and family addresses of clients, staff, volunteers, student interns, and administrative team members;
3. Names of clients, staff, volunteers, and student interns, unless written permission is provided by the individual and approved by the Executive Director;
4. Photographs taken of clients, staff or volunteers.
Volunteers must never release confidential information, either over the phone or in person, about MM and its clients without the express permission of the Executive Director or a designated staff member. This includes release of information to administrative personnel, criminal justice personnel, family members, community supporters, or other interested parties.
I have read the MM Confidentiality Agreement and I agree to abide by its conditions of confidentiality. I understand that these conditions apply to me as I serve as a volunteer and continue to be binding on me when I leave MM, and that a violation may be grounds for termination of volunteer status and possible civil liability.
Consent Form for Criminal Background Check (CBC)
I hereby give my permission for Mission Marshall (MM) to obtain information relating to my criminal history record through Background Information Services, Inc. The criminal history record, as received from the reporting agencies, may include arrest and conviction data as well as plea bargains and deferred adjudications and delinquent conduct as committed as a juvenile. I understand that this information will be used, in part, to determine my eligibility for an employment/volunteer position with this organization. I also understand that as long as I remain an employee or volunteer here, the crimin?I histon/ records check may be repeated at any time. I understand that I will have an opportunity to review the criminal history as received by MM and a procedure is available for clarification, if I dispute the record as received. I also understand that the criminal history could contain information presumed to be expunged.
I, the undersigned, do, for myself, my heirs, executors and administrators, hereby remise, release and forever discharge and agree to indemnify MM and each of its officers, directors, employees and agents and hold harmless from and against any and all caused of actions, suits, liabilities, costs, debts and sums of money, claims and demands whatsoever (including expenses resulting from the investigation of my background in connection with my application to become a volunteer/staff member.