Volunteer Release form for Whole Way House
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Mailing Address *
Whole Way House-Code of Conduct SPECIAL COVID RELEASE
SPECIAL PANDEMIC (COVID-19) RESPONSE PLAN AGREEMENT:

- I agree to follow the instructions of the staff, the health authority and our government.
- I agree to self-monitor daily for signs and symptoms of illness and not attend my shift if I am feeling ill or have been instructed by public health to self-isolate
- I agree to wear the appropriate PPE (personal protective equipment) as instructed by Whole Way House staff
- I agree to follow infection prevention and control protocols including diligent hand hygiene
- I will practice physical distancing of 2m when possible and wear appropriate face coverings.
- I agree to avoid close contact with others when travelling to and from shifts.
- I agree to stay with a staff member at all times.

1. I agree to behave in a kind and respectful manner with any and all people at WWH. I will treat others as I would like to be treated.
2. I agree to not counsel or advise attendees, but to solely offer compassion and support.
3. I agree to dress appropriately (no revealing clothing please).
4. I agree to act in a safe manner, for my safety and the safety of those around me. I will not bring weapons into WWH - including pocket knives. I will wear closed toed shoes and will take care of myself so that I can help take care of others at WWH. I agree to speak to a staff member if an issue arises regarding safety, harassment or anything else that may put myself or others in danger or at risk, including information regarding thoughts of suicide or harming a minor.
5. I agree to tell a staff member or call the appropriate authorities if someone shares information regarding thoughts of suicide or harming a minor.
6. I agree to an oath of confidentiality outside of WWH. I will not share personal or professional information regarding WWH, its
staff or attendees outside of WWH, or photograph any of the events or attendees.
7. I agree to not push my religion, beliefs, political views or any such thoughts that may infringe on the comfort of WWH staff, volunteers, interns and/or attendees.
8. I agree to be a team-player by following the instructions of the WWH staff to the best of my ability, and working with others to benefit the charity and the attendees of WWH.
9. I agree to be sober, not use vulgar language while at WWH.
10. I agree that Whole Way House, it’s staff and/or Board of Directors will not be held responsible for my physical, mental, or emotional well being. I acknowledge that WWH will do it’s best to keep a safe and healthy environment, however, I agree that volunteering/interning at WWH is my choice and will not hold them responsible for any harm that may come my way. I understand the purpose of WWH is to help those in need in Vancouver’s downtown eastside and that it can be a dangerous area. I will do my best to stay out of dangerous situations, and behave in a way that does not provoke violence or danger of any kind. I will remove myself physically from any altercation or high risk scenario.
11. I will not accept or receive gifts of any kind from the attendees of WWH. In the event that I wish to gift an attendee, I will donate through WWH. I will not accept invitations to the attendees home or to be alone or to be unsupervised by a WWH staff member. I will speak to a staff member about any and all invitations from an attendee that are outside of a WWH program.
12. I agree to respect and protect personal information by only revealing generalized information about myself (no Facebook, addresses, phone numbers etc.), and maintaining a first name basis with WWH’s attendees.
13. I will contribute to a safe and healthy workplace, and respect attendees’ personal space by not engaging in any form of physical contact.
14. I understand that WWH may photograph events for photo albums, social media uses or other purposes. I agree to inform the photographer in the event that I do not wish to be photographed.

Name of your group or organization (if applicable)
Your Name *
Phone Number
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Your Email Address *
How did you hear about Whole Way House?
Facebook, Twitter, Instagram, Website, a friend (please name), other
Follow us on Facebook and Instagram @wholewayhouse to see pictures that we take of your group!
By typing my full name, I consent to abiding by the Whole Way House Code of Conduct, and do not hold Whole Way House Society liable for my safety or well-being. (Must be 19+ or a Parent/Guardian) *
Parent/Guardian Name (if applicable)
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