WAIVER AND RELEASE
I understand and acknowledge that there are risks involved in volunteering with the Idaho Youth Ranch.
1. I assume the risk and full responsibility for any and all injuries, losses or damages which might occur to me while volunteering for the Idaho Youth Ranch to the maximum extent allowed by law.
2. I waive and release any and all claims, suits or related causes of action against IYR and its directors, officers, employees, volunteers, agents or affiliates for injury, loss, death, costs or other damages to me or to my heirs and assigns.
3. I indemnify and hold IYR harmless, to the maximum extent allowed by law, from any injury, loss, death, costs or other damages to me, my heirs or assigns or any third parties for claims, suits, or other related causes of action asserted against IYR arising from my conduct while volunteering for IYR.
4. I release, indemnify and hold IYR harmless from any liability whatsoever for future claims pursued by my heirs and assigns for any injury, losses or damages.
5. I give to IYR my free and unlimited consent and permission, waiving all claims for any compensation or damages by reason thereof, to use, publish, republish, or exhibit, with or without identification of me by name, any photographs, videos or statements taken that are related to my volunteering with IYR. IYR may use any of these materials in the furtherance of its work in the promotion of IYR or in any of its fund campaigns or other activities.
CERTIFICATION
My signature below certifies that all information in this application is correct and complete to the best of my knowledge and belief and I understand that intentionally giving false or incomplete information may result in refusal of volunteer services or termination of volunteer services if discovered after the start date. I also authorize the employers, schools, or persons named to provide information regarding my employment, education, character, and qualifications. I understand that information obtained from the persons named or others will be used for the purpose of making volunteer service related decisions and that the results will be kept strictly confidential.
I understand that pre-service drug testing may be required for this position. If a criminal background check or medical examination is required for the position for which I am applying, any offer is contingent upon satisfactory completion of such background check and/or testing.
I also understand and agree that if selected, my volunteer service is for no definite period and either the Agency or I may terminate our relationship at will at any time without notice or reason and that this application does not constitute a contract.
I have carefully read this release of liability, hold harmless and indemnification agreement and, by my signature below, I understand and agree to the above terms and conditions.
Equal Employment Opportunity
We are an Equal Opportunity employer and do not discriminate on the basis of race, ancestry, color, religion, sex, age, marital status, sexual orientation, national origin, medical condition, disability, veteran status, or any other basis protected by law.
The Information provided will be used for research, reporting, statistical purposes and to monitor legal compliance. To help us comply with these government requirements, please complete the following information.
Completion of this form is voluntary and will not affect your opportunity for employment or terms or conditions of employment if hired. We appreciate your cooperation.
Gender
Male
Female
I choose not to disclose this information
Ethnicity
Hispanic or Latino (a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race)
Not Hispanic or Latino (if not Hispanic or Latino, please address race below)
I choose not to disclose this information
Race (do not respond if you selected "Hispanic or Latino" above)
White (Not Hispanic or Latino)
A person having origins in any of the original peoples of Europe, the Middle East, or North Africa
Asian (Not Hispanic or Latino)
A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam
American Indian or Alaska Native (Not Hispanic or Latino)
A person having origins in any of the original peoples of North and South America (including Central America), and who maintain tribal affiliation or community attachment
Black or African American (Not Hispanic or Latino)
A person having origins in any of the black racial groups of Africa
Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino)
A person having origins in any of the peoples of Hawaii, Guam, Samoa, or other Pacific Islands
Two or More Races (Not Hispanic or Latino)
All persons who identify with more than one of the above five races
I choose not to disclose this information
Protected Veterans
The definitions of protected veterans are listed below. Use the boxes following the definitions to indicate whether you are a protected veteran
Disabled Veteran
A "disabled veteran" is one of the following:
A veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or
A person who was discharged or released from active duty because of a service-connected disability.
Recently Separated Veteran
A "recently separated veteran" means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service.
Active Duty Wartime or Campaign Badge Veteran
An "active duty wartime or campaign badge veteran" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.
Armed Forces Service Medal Veteran
An "armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.
I am not a Protected Veteran
I choose not to disclose this information
Disability Status
You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition.
Yes I have a disability (or previously had one)
No I don't have a disability