The Lighthouse for Women & Children Volunteer Application Name* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Email* Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code 17 years of age or younger? Yes Home PhoneCell PhoneGroup / Church Name*If volunteer is under 18, a parent/legal guardian's signature is required. ExperienceEducationSchoolOccupationEmployerVolunteer ExperienceSkills Interests Food service Mentoring/counseling Recreation/sports Office/administration Computers Food/hygiene drives Teaching/tutoring Children/youth Other Interests OtherWhy would you like to be a Lighthouse For Women & Children Volunteer?How did you learn about The Lighthouse for Women & Children?Have you received services from The Lighthouse for Women & Children or any other rescue mission? Yes No Please give name of rescue mission, date(s) of services, and outcomeAvailabilityI would like to volunteer... Occasionally Weekly Monthly Long Term I am available... Morning Afternoon Evening Morning Days Monday Tuesday Wednesday Thursday Friday Saturday Sunday Afternoon Days Monday Tuesday Wednesday Thursday Friday Saturday Sunday Evening Days Monday Tuesday Wednesday Thursday Friday Saturday Sunday Emergency Contact(s)Name First Last PhoneRelationName First Last PhoneRelationVOLUNTEER GENERAL INFORMATION AND POLICIES Ventura County Rescue Mission (VCRM) an outreach of Rescue Mission Alliance (RMA) will not tolerate any form of harassment (verbal or physical) exploitation or intimidation of any nature from volunteers, interns, staff members, program participants or guests. We are a rescue mission that provides emergency services and recovery programs for the poor and homeless. Please maintain a friendly but respectful and professional interaction with our mission guests and clients. Do not assist any guest or resident with money, medication, gifts or transportation. Do not give out personal contact information, including email addresses or phone numbers. Should a guest or resident request to contact you personally, please report to the Volunteer Coordinator. Please be sensitive to the personal space of our guests (men, women and children). Ask permission before touching any guest or resident for any reason. DRESS CODE/SAFETY ISSUES Administrative volunteers may wear casual clothing appropriate for a professional business environment. All non-administrative volunteers must wear closed-toe and closed-heel shoes. Wear modest clothing you are comfortable moving in and don’t mind getting a little dirty! All volunteers should be aware that by volunteering in any area assigned, you may be subjecting yourself to wet floors, sharp kitchen utensils, and all such related safety issues of that workspace, and if not careful could potentially result in bodily harm to you or others around you. VCRM is not responsible for any accidents that may occur while you are volunteering at this facility or any of the offsite locations where we conduct outreach or special activities. GENERAL CODE OF CONDUCT RULES As a volunteer you represent VCRM to the public. You accept responsibility for this status and will conduct yourself in a professional manner. You are expected to be clean and sober when participating as a VCRM volunteer. You must maintain the confidentiality of all volunteers, clients, guests, residents and donors about whom you have personal or identifying information. You must not participate in and will report any and all instances of any sort of harassment, exploitation, and/or intimidation. You must maintain an atmosphere of physical and emotional safety for everyone associated with VCRM including but not limited to employees, volunteers, clients, guests, residents and visitors. VCRM is an organization assisting vulnerable men, women and children. No one who has ever been indicted or convicted of a violent crime, child abuse or neglect, child pornography, child abduction, kidnapping, rape or sexual offense may serve as a volunteer. As a volunteer, your activities may include potential hazards, including but not limited to (a) physical activity (including without limitation work with heavy tools and materials), (b) contact with unidentified and unfamiliar persons, (c) travel to and from various unspecified locations and (d) other potential risk of injury. You must be willing to provide volunteer service with the knowledge of the potential hazards involved and agree to accept any and all risks of injury without any recourse to or against VCRM. Photo and Material ReleaseName First Last name of parent/legal guardian if the volunteer is a minorDate Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country By filling out the fields and submissions below, I hereby give the Rescue Mission Alliance the absolute and irrevocable right and unrestricted permission concerning any photographs that are taken or may be taken of me or in which I may be included with others, to use, reuse, publish, and republish the photographs in whole or in part, individually or in connection with other material, in any and all media now or hereafter known, including the internet, and for any purpose whatsoever, specifically including illustration, promotion, art, editorial, advertising, and trade, without restriction as to alteration; and to use my name in connection with any use if they so choose. I release and discharge Rescue Mission Alliance from any and all claims and demands that may arise out of or in connection with the use of the photographs, including without limitation any and all claims for libel or violation of any right of publicity or privacy. This authorization and release shall also inure to the benefit of the heirs, legal representatives, licensees, and assigns of Rescue Mission Alliance, as well as the person(s) who took the photographs. I am a legally competent adult and have the right to contract in my own name. I have read this document and fully understand its contents. This release shall be binding upon me and my heirs, legal representatives, and assigns. If subject is not yet (18) years old, the child’s parent or guardian must complete and sign the following: Minor's name (if applicable) First Last By filling out the fields and submissions below, I hereby warrant that I am the parent/guardian of the minor, and have full authority to authorize the above release, which I have read and approved. I hereby release and agree to indemnify the licensed parties and their respective successors and assigns, from and against any and all liability arising out of the exercise of the rights granted by the above release. I wish to volunteer for The Lighthouse for Women & Children or its affiliates (together with RMA).* Yes SignaturePhoneThis field is for validation purposes and should be left unchanged.