COVID-19 SMM Volunteer Interest Form

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The SMM Volunteer Interest Form is designed for those who are interested in signing up to volunteer and serve during COVID-19 with agencies that SendMeMissions has verified are accepting volunteers and have volunteer needs. Once the form has been completed, you can expect to be contacted within 48 hours with additional information about each volunteer opportunity you are interested in.

Email *

The following agencies are currently accepting Volunteers during COVID-19 and our agency has verified the need. Please select ALL opportunities that you would like to receive specific information about: *

IMMEDIATE NEED: First United Methodist Church Food Distribution 5/14/20 10am-1pm

Hardee County Schools - Delivering & Packaging Food (Hardee Residents Only)

Hardee Help Center - Variety of Tasks (i.e., unloading food, delivering food, elderly outreach) (Hardee Residents Only)

SendMeMissions - Remote Administrative Assistance (i.e., emails, phone calls, data input)

One Day Food Distributions (Dates vary and are often added with short notice) (Hardee Residents Only)

Pick Up or Deliver Resources/Donations (masks, gloves, hand sanitizer, etc) (Hardee Residents Only)

Required

Full Name (First, Middle, Last) *

Male or Female *

Age / Birthdate *

Parent or Legal Guardian's Name and Contact Information (if under 18 years of age)

Physical Address *

Mailing Address (if different from physical address)

Telephone # *

Preferred Method of Contact *

Call between 8am-5pm

Call between 6pm-8pm

Text

Required

Are you willing to have a background check completed? (free of charge) *

Yes

Not Applicable - I'm a minor (Under the age of 18)

Are you aware of any physical problems that may limit you? Please explain:

Are you part of a local church? If yes, please list church name:

Emergency Contact (Name & Number)

Volunteer Liability Release

In consideration of my desire to serve as a volunteer in disaster relief efforts to be conducted by SendMeMissions, Inc. (SMM), I hereby assume all responsibility for any and all risk of property damage or bodily injury that I may sustain while participating in any voluntary relief effort, disaster exercise or other activity of any nature, including the use of equipment and facilities of SMM.

Further, I, for myself and my heirs, executors, administrators and assigns, hereby release, waive and discharge SMM and its officers, directors, employees, agents and volunteers of and from any and all claims which I or my heirs, administrators and assigns ever may have against any of the above for, on account of, by reason of or arising in connection with such volunteer relief efforts or my participation therein, and hereby waive all such claims, demands and causes of action.

Further, I expressly agree that this release, waiver and indemnity agreement is intended to be as broad and inclusive as permitted by the laws of the State of Florida, and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

I currently have no known physical or mental condition that would impair my capability for full participation as intended or expected of me.

Further, I have carefully read the foregoing release and indemnification and understand the contents thereof and sign this release as my own free act.

I have read and agree to the above release *

Yes

Send me a copy of my responses.

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