Volunteer Agreement

This volunteer agreement includes a release and waiver of liability and non-disclosure and confidentiality agreements. Please read through the document carefully and contact ACHA’s Membership & Volunteer Coordinator with questions.

Volunteer Contact Information

You must be at least 18 years of age
Must be a valid email address

Emergency Contact Information

Areas of Volunteer Interest/Skill Set (Select all that apply)

Please include any special skills, education or certifications here.

Release and Waiver of Liability

PLEASE READ CAREFULLY! THIS IS A LEGAL DOCUMENT THAT AFFECTS YOUR RIGHTS.

This Release and Waiver of Liability (the "Release") is executed on this 16 day of October, 2019, in favor of Adult Congenital Heart Association, a Pennsylvania non-profit corporation, its directors, officers, employees, and agents (collectively, "ACHA").

The Volunteer desires to work as a volunteer for ACHA and to engage in the activities related to being a volunteer. The volunteer understands that the activities may include working in the ACHA office or in the community on ACHA’s behalf. The Volunteer does hereby freely, voluntarily, and without duress execute this Release under the following terms:

1. Waiver and Release. Volunteer does hereby release and forever discharge and hold harmless ACHA and its successors and assigns from any and all liability, claims and demands of whatever kind or nature, either in law or in equity, which arise or may hereafter arise from Volunteer's work for ACHA. Volunteer understands and acknowledges that this Release discharges ACHA from any liability or claim that the Volunteer may have against ACHA with respect to any bodily injury, personal injury, illness, death or property damage that may result from Volunteer's work for ACHA, whether caused by the negligence of ACHA or its officers, directors, employees, agents, volunteers, or otherwise. Volunteer also understands that, except as otherwise agreed to by ACHA in writing, ACHA does not assume any responsibility for or obligation to provide financial assistance or other assistance, including but not limited to medical , health, or disability insurance, in the event of injury or illness.

2. Medical Treatment.Except as otherwise agreed to by ACHA in writing, Volunteer does hereby release and forever discharge and hold harmless ACHA and its successors and assigns from any and all liability or claims which arise or may hereafter arise on account of any first aid, treatment, or service rendered in connection with Volunteer's work for ACHA.

3. Insurance. The Volunteer understands that, except as otherwise agreed to by ACHA in writing; ACHA does not carry or maintain health, medical, or disability insurance coverage for any Volunteer. Each volunteer is expected and encouraged to obtain his or her own medical or health insurance coverage.

4. Photographic Release. Volunteer does hereby grant and convey unto ACHA all rights, title, and interest in any and all photographic images and video or audio recordings made by ACHA during the Volunteer's work for ACHA, including, but not limited to, any royalties, proceeds, or other benefits derived from such photographs or recordings. For the duration of service, the Volunteer hereby grants to ACHA a worldwide, royalty-free, non-exclusive, perpetual (for the duration of the applicable copyright) license to reproduce any photograph(s), to incorporate the photograph(s) into one or more Collective Works (including but not limited to the ACHA Update e-newsletter, ACHA’s website, and any other media or publications as the Adult Congenital Heart Association deems appropriate), and to reproduce the photograph(s) as incorporated in the Collective Works. This includes photographs taken by ACHA staff members during any event or activity at which the Volunteer is present or photographs submitted by the Volunteer.

Confidentiality & Non-Disclosure Agreement

Employees, volunteers and board members of the Adult Congenital Heart Association (ACHA) may be exposed to information which is confidential and/or privileged and proprietary in nature. It is the policy of ACHA that such information must be kept confidential both during and after employment or volunteer service. Staff and volunteers are expected to return materials containing privileged or confidential information at the time of separation or expiration of service.

Any director, committee member, volunteer or staff member that divulges confidential or privileged information, whether during or after his/her term of service or employment, is subject to appropriate discipline, including dismissal. Directors, committee members, volunteers and staff recognize that ACHA has a proprietary interest in any such information and/or documents and would be irreparably damaged as a result of any disclosure or dissemination thereof.

ACHA has a legal and ethical responsibility to safeguard the confidentiality of member health and donation information. During my volunteer service with ACHA, I may come into possession of confidential information.

I understand that such information must be maintained in the strictest confidence. As a condition of my volunteer service, I hereby agree that, unless directed by my supervisor, I will not at any time during or after my service with ACHA disclose any confidential information to any person whatsoever or permit any person whatsoever to examine or make copies of any confidential information coming into my possession or under my control, or use any information other than as necessary in the course of my volunteer service.

By signing and submitting this volunteer agreement, I agree to abide by ACHA’s volunteer policies and have reviewed the Volunteer Handbook. I certify that this information is true and accurate to the best of my knowledge, and I release and hold harmless Adult Congenital Heart Association for any inaccuracy or misrepresentation. I understand any violation of these policies may result in corrective action, up to and including discharge of my volunteer service.

10/16/2019