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Required fields are marked with an asterisk (*). First Name *
Last Name *
Home Address *
City *
State *
Zip Code *
Date of Birth (month/day/year) *
A valid date as MM/DD/YYYY (for example: 11/30/2015)
Phone Type *
Have you volunteered with Habitat in the past? *
Organization *
Shirt Size *
Emergency Contact *
Emergency Contact's Relationship to You *
Construction Experience *
Emergency Contact's Phone Number *
Emergency Contact's Phone Type *
Youth must return a hard copy of their waiver, signed by a parent or legal guardian. *
Code of Conduct
Iowa Heartland Habitat for Humanity is committed to a work environment in which all individuals are treated with respect and dignity. Each individual has the right to work or volunteer in a professional atmosphere that promotes equal employment opportunities and prohibits unlawful discriminatory practices, including harassment. Therefore, Iowa Heartland Habitat for Humanity expects that all relationships among paid or volunteer persons in the office, on the construction site, in the Iowa Heartland Habitat for Humanity ReStore, and on home repair projects will be business-like and free of explicit bias, prejudice and harassment.
Iowa Heartland Habitat for Humanity has developed these policies to ensure that all its employees and volunteers can work in an environment free from unlawful harassment, discrimination and retaliation. Iowa Heartland Habitat for Humanity will make every reasonable effort to ensure that all concerned are familiar with these policies and are aware that any complaint in violation of such policies will be investigated and resolved appropriately.
Any person who has questions or concerns about these policies should talk with the executive director or a member of the board of directors.
These policies should not, and may not, be used as a basis for excluding or separating individuals of a particular gender, or any other protected characteristic, from participating in business or work-related social activities or discussions. In other words, no one should make the mistake of engaging in discrimination or exclusion to avoid allegations of harassment. The law and the policies of Iowa Heartland Habitat for Humanity prohibit disparate treatment on the basis of sex or any other protected characteristic, with regard to terms, conditions, privileges and perquisites of employment. The prohibitions against harassment, discrimination and retaliation are intended to complement and further those policies, not to form the basis of an exception to them.
Equal Employment Opportunity
It is the policy of Iowa Heartland Habitat for Humanity to ensure equal employment and volunteer opportunity without discrimination or harassment on the basis of race, color, religion, sex, sexual orientation, gender identity or expression, age, disability, marital status, citizenship, national origin, genetic information, or any other characteristic protected by law. Iowa Heartland Habitat for Humanity prohibits any such discrimination or harassment.
Retaliation
Iowa Heartland Habitat for Humanity encourages reporting of all perceived incidents of discrimination or harassment. It is the policy of Iowa Heartland Habitat for Humanity to promptly and thoroughly investigate such reports. Iowa Heartland Habitat for Humanity prohibits retaliation against any individual who reports discrimination or harassment or participates in an investigation of such reports.
Sexual Harassment
Sexual harassment constitutes discrimination and is illegal under federal, state and local laws. For the purposes of this policy, “sexual harassment” is defined, as in the Equal Employment Opportunity Commission Guidelines, as unwelcome sexual advances, requests for sexual favors and other verbal or physical conduct of a sexual nature when, for example: a) submission to such conduct is made either explicitly or implicitly a term or condition of an individual’s employment or ability to volunteer, b) submission to or rejection of such conduct by an individual is used as the basis for employment or volunteering decisions affecting such individual, or c) such conduct has the purpose or effect of unreasonably interfering with an individual’s work or volunteering performance or creating an intimidating, hostile or offensive working or volunteering environment.
Title VII of the Civil Rights Act of 1964 recognizes two types of sexual harassment: a) quid pro quo and b) hostile work environment. Sexual harassment may include a range of subtle and not-so-subtle behaviors and may involve individuals of the same or different gender. Depending on the circumstances, these behaviors may include unwanted sexual advances or requests for sexual favors; sexual jokes and innuendo; verbal abuse of a sexual nature; commentary about an individual’s body, sexual prowess or sexual deficiencies; leering, whistling or touching; insulting or obscene comments or gestures; display of sexually suggestive objects or pictures; and other physical, verbal or visual conduct of a sexual nature.
Harassment
Harassment on the basis of any other protected characteristic is also strictly prohibited. Under this policy, harassment is verbal, written or physical conduct that denigrates or shows hostility or aversion toward an individual because of his or her race, color, religion, sex, sexual orientation, gender identity or expression, national origin, age, disability, marital status, citizenship, genetic information, or any other characteristic protected by law, or that of his or her relatives, friends or associates, and that: a) has the purpose or effect of creating an intimidating, hostile or offensive work or volunteering environment, b) has the purpose or effect of unreasonably interfering with an individual’s work or volunteer performance, or c) otherwise adversely affects an individual’s employment or volunteering opportunities.
Harassing conduct includes epithets, slurs or negative stereotyping; threatening, intimidating or hostile acts; denigrating jokes; and written or graphic material that denigrates or shows hostility or aversion toward an individual or group that is placed on walls or elsewhere on the premises or circulated in the workplace, ReStore or build/repair sites, on company time or using company equipment by e-mail, phone (including voice messages), text messages, social networking sites or other means.
Individuals and Conduct Covered
These policies apply to all employees, volunteers, vendors and contractors, whether related to conduct engaged in by fellow employees and volunteers or by someone not directly connected to Iowa Heartland Habitat for Humanity (e.g., an outside vendor, consultant or customer).
Conduct prohibited by these policies is unacceptable in the workplace, ReStore, or build/repair sites and in any work-related setting outside the workplace, such as during business trips, business meetings and business-related social events.
Reporting an Incident of Harassment, Discrimination or Retaliation
Iowa Heartland Habitat for Humanity encourages reporting of all perceived incidents of discrimination, harassment or retaliation, regardless of the offender’s identity or position. Individuals who believe that they have been the victim of such conduct should discuss their concerns with their immediate supervisor, the executive director or any member of the board of directors if their supervisor or the executive director is the person in question. See the complaint procedure described below.
In addition, Iowa Heartland Habitat for Humanity encourages individuals who believe they are being subjected to such conduct to promptly advise the offender that his or her behavior is unwelcome and to request that it be discontinued. Often this action alone will resolve the problem. Iowa Heartland Habitat for Humanity recognizes, however, that an individual may prefer to pursue the matter through complaint procedures.
Complaint Procedure
Individuals who believe they have been the victims of conduct prohibited by this policy or believe they have witnessed such conduct should discuss their concerns with their immediate supervisor, the executive director or any member of the board of directors if their supervisor or the executive director is the person in question.
Iowa Heartland Habitat for Humanity encourages the prompt reporting of complaints or concerns so that rapid and constructive action can be taken before relationships become irreparably strained. Therefore, while no fixed reporting period has been established, early reporting and intervention have proven to be the most effective method of resolving actual or perceived incidents of harassment.
Any reported allegations of harassment, discrimination or retaliation will be investigated promptly. The investigation may include individual interviews with the parties involved and, where necessary, with individuals who may have observed the alleged conduct or may have other relevant knowledge.
Iowa Heartland Habitat for Humanity will maintain confidentiality throughout the investigatory process to the extent consistent with adequate investigation and appropriate corrective action.
Retaliation against an individual for reporting harassment or discrimination or for participating in an investigation of a claim of harassment or discrimination is a serious violation of this policy and, like harassment or discrimination itself, will be subject to disciplinary action. Acts of retaliation should be reported immediately and will be promptly investigated and addressed.
Misconduct constituting harassment, discrimination or retaliation will be dealt with appropriately. Responsive action may include, for example, training, referral to counseling or disciplinary action such as a warning, reprimand, withholding of a promotion or pay increase, reassignment, temporary suspension without pay, or termination, as Iowa Heartland Habitat for Humanity believes appropriate under the circumstances.
If a party to a complaint does not agree with its resolution, that party may appeal to Iowa Heartland Habitat for Humanity’s executive director or the board of directors.
False and malicious complaints of harassment, discrimination or retaliation (as opposed to complaints that, even if erroneous, are made in good faith) may be the subject of appropriate disciplinary action.
Code of Conduct Signature *
Waiver
Volunteer Agreement, Release and Waiver of Liability, Assumption of Risk, and Indemnification Agreement
This is a legal document that affects your legal rights; please read carefully.
The undersigned individual and, if applicable, guardian (the "Volunteer") execute this Volunteer Agreement, Release and Waiver of Liability, Assumption of Risk, and Indemnification Agreement ("Agreement") in favor of Iowa Heartland Habitat for Humanity, Habitat for Humanity International, Inc. and any other Habitat for Humanity affiliated organization, and their respective affiliates, directors, officers, trustees, employees, sponsors, donors, volunteers and agents (collectively, the "Released Parties").
I, the Volunteer, desire to work as a volunteer for one or more of the Released Parties without compensation and engage in the activities related to being a volunteer. I understand that my activities may include but are not limited to the following: working at Habitat for Humanity offices and worksites; working in or for Habitat for Humanity ReStore operations; loading and unloading materials; traveling to and from work sites, towns, cities or countries; consuming food available or provided; living in housing provided for volunteers; assisting in disaster relief areas; constructing and rehabilitating residential buildings; other construction-related activities; and other volunteer activities ("Activities"). I understand that I may decline to engage in any Activity at any time for any reason.
I, the Volunteer, understand that my Activities may include work that may be hazardous to me, including, but not limited to, exposure to lead, asbestos, and mold, which may cause or worsen certain illnesses, especially if I do not wear protective equipment, am exposed for extended periods of time, or have a pre-existing immune system deficiency. I understand that construction work or my presence at a construction site involves inherent risks.
I also understand there is some inherent risk in consuming local foods and living in local accommodations in the city(ies) or country(ies) visited. I further understand I may be traveling to and from locations where there is a risk of terrorism, war, insurrection, criminal activities, instability, inclement weather or other circumstances that could threaten my health or safety. I also understand that it is the policy of the Released Parties not to pay ransom or make any other payments to secure the release of hostages.
I, the Volunteer, hereby freely, voluntarily and without duress execute this Agreement under the following terms:
Release and Waiver. In consideration of and in order to be allowed to participate in the Activities, I, the Volunteer, do hereby release and forever discharge and hold harmless the Released Parties and their successors and assigns from any and all liability, claims, demands, costs and damages of any kind, whether arising from tort, contract or otherwise, which I or my heirs, assigns, next of kin or legal representatives may have or which may hereinafter accrue, arise from, or are in any way related to my Activities with any of the Released Parties, including but not limited to personal injury, bodily injury, illness, property damage, loss or death, whether caused wholly or in part by the simple negligence, fault or other misconduct of any of the Released Parties or of other volunteers, other than their intentional or grossly negligent conduct.
I understand and acknowledge that by signing this Agreement I knowingly assume the risk of injury, harm, damage and loss associated with the Activities. I also understand that the Released Parties do 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, illness, death or property damage.
I understand and acknowledge that children under the age of 16 are not allowed on Habitat for Humanity worksites while construction is in progress. While minors between the ages of 16 and 18 may be allowed to participate in some types of construction work, I understand that using power tools, excavation, demolition, working on rooftops and similar activities are not permitted for anyone under the age of 18. I agree it is my responsibility to communicate these requirements to any of my minor children who will attend and/or participate in the Activities.
Assumption of Risk. I understand that I will be afforded every opportunity and should insist upon every opportunity to investigate and inspect the jobsite, facilities, and general condition of any location in which I may be present. I acknowledge that I will be afforded and should insist upon every opportunity to discuss the risks and harms, both generally and particular to the circumstances present, with the Released Parties or an agent thereof. I agree that I will ensure that any questions or concerns I have will be raised and adequately addressed before I engage in any Activity. I agree that my duty under this paragraph is continuing in nature throughout the course of my Activities. I agree to assume all risk and full responsibility for any risk of harm of any kind associated with the performance of any Activities or activities incidental thereto.
Indemnification. I further agree to indemnify and hold harmless the Released Parties to the full extent of any liability or financial or other responsibility arising out of or related in any way to the performance of any Activities or activities incidental thereto, including but not limited to personal injury claims, consortium claims, and property damage claims; whether such claim is brought by Volunteer or any third party. Such indemnification shall include all associated costs, including reasonable attorney fees incurred in preparing for or defending against any or all claims or causes of action contemplated or actually pursued, whether or not the action is actually filed, arising out of or in any way related to the performance of the Activities or activities incidental thereto.
Consent to Transportation and Medical Treatment. I consent to the use of first aid treatment and the use of generic and over the counter medications and treatments as directed by manufacturer labels, whether administered by the Released Parties or first aid personnel. In an emergency, I understand the Released Parties may try to contact the individual listed as an emergency contact. If an emergency contact cannot be reached promptly, I hereby authorize the Released Parties to act as an agent for me to consent to any examination, testing, x-rays, medical, dental or surgical treatment for me as advised by a physician, dentist or other health care provider. This includes, but is not limited to, my assessment, evaluation, medical care and treatment, anesthesia, hospitalization, or other health care treatment or procedure as advised by a physician, dentist or other health care provider. I also authorize the Released Parties to arrange for transportation of me as deemed necessary and appropriate in their discretion. I, the Volunteer, do hereby release, forever discharge and hold harmless the Released Parties from any liability, claim, demand, and action whatsoever brought by me or on my behalf which arises or may hereafter arise on account of any transportation, first aid, assessment, care, treatment, response or service rendered in connection with my Activities with any of the Released Parties.
If the Volunteer is less than 18 years of age, the parent(s) having legal custody and/or the legal guardian(s) of the Volunteer also hereby release, forever discharge and hold harmless the Released Parties from any liability, claim, demand and action whatsoever brought by such volunteer or on his/her behalf which arises or may hereafter arise on account of the decision by any representative or agent of the Released Parties to exercise the power to transport, administer first aid, and consent to assessment, examination, x-rays, medical, dental, surgical or other such health care treatment as set forth in the Parental Authorization for Treatment of, and Travel With, a Minor Child.
Insurance. I understand that, except as otherwise agreed to by the Released Parties in writing, the Released Parties are under no obligation to provide, carry or maintain health, medical, travel, disability or other insurance coverage for any Volunteer. Each Volunteer is expected and encouraged to obtain his or her own health, medical, travel, disability or other insurance coverage.
I understand that I am and remain responsible for payment of such hospital, physician, ambulance, dental, medical or other services obtained for me or my child. I agree that the Released Parties do not assume any responsibility for the payment of such fees or expenses which may be incurred. If I have health insurance, I understand my personal health insurance is my primary coverage.
Confidentiality. I agree that in the course of my participation in the Activities, I may have access to personal and/or health care information of other persons. I agree to maintain the confidentiality of such information, to use such information only as necessary to do my job as a volunteer, and to comply with Habitat for applicable policies regarding such information.
Photographic/Recording Release and Consent. I hereby grant and convey unto Habitat for Humanity International, Inc. all right, title and interest in any and all photographs and video/audio/electronic recordings of me, including as to my name, image and voice, made by or on behalf of any of the Released Parties during my Activities with the Released Parties, including, but not limited to, the right to use such materials for any purpose and to any royalties, proceeds or other benefits derived from them. I understand that I will not have any ownership interest in or to such photographs, images and/or recordings, I have not been provided or promised any compensation to me, and I hereby waive any rights, privileges or claims based on any right of publicity, privacy, ownership or any other rights arising, relating to or resulting from the photographs, images and/or recordings. I understand and agree that this paragraph also applies to my minor child(ren) who are volunteering.
Other. I expressly agree that this Agreement is intended to be as broad and inclusive as permitted by applicable law. I further agree that in the event any clause or provision of this Agreement is held invalid by any court of competent jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining clauses or provisions of this Agreement, which shall continue to be enforceable. Further, a waiver of a right under this Agreement by a Released Party does not prevent the exercise of any other right.
I have carefully considered my decision, the benefits and risks involved and hereby give my informed consent to participate in all volunteer Activities. I have read and understand this Agreement, any questions of mine have been answered, and I voluntarily agree to the above provisions. It is my intent to bind my heirs, next of kin, assigns, beneficiaries and legal representative.
Volunteer Agreement, Release and Waiver of Liability, Assumption of Risk, and Indemnification Agreement
This is a legal document that affects your legal rights; please read carefully.
The undersigned individual and, if applicable, guardian (the "Volunteer") execute this Volunteer Agreement, Release and Waiver of Liability, Assumption of Risk, and Indemnification Agreement ("Agreement") in favor of Iowa Heartland Habitat for Humanity, Habitat for Humanity International, Inc. and any other Habitat for Humanity affiliated organization, and their respective affiliates, directors, officers, trustees, employees, sponsors, donors, volunteers and agents (collectively, the "Released Parties").
I, the Volunteer, desire to work as a volunteer for one or more of the Released Parties without compensation and engage in the activities related to being a volunteer. I understand that my activities may include but are not limited to the following: working at Habitat for Humanity offices and worksites; working in or for Habitat for Humanity ReStore operations; loading and unloading materials; traveling to and from work sites, towns, cities or countries; consuming food available or provided; living in housing provided for volunteers; assisting in disaster relief areas; constructing and rehabilitating residential buildings; other construction-related activities; and other volunteer activities ("Activities"). I understand that I may decline to engage in any Activity at any time for any reason.
I, the Volunteer, understand that my Activities may include work that may be hazardous to me, including, but not limited to, exposure to lead, asbestos, and mold, which may cause or worsen certain illnesses, especially if I do not wear protective equipment, am exposed for extended periods of time, or have a pre-existing immune system deficiency. I understand that construction work or my presence at a construction site involves inherent risks.
I also understand there is some inherent risk in consuming local foods and living in local accommodations in the city(ies) or country(ies) visited. I further understand I may be traveling to and from locations where there is a risk of terrorism, war, insurrection, criminal activities, instability, inclement weather or other circumstances that could threaten my health or safety. I also understand that it is the policy of the Released Parties not to pay ransom or make any other payments to secure the release of hostages.
I, the Volunteer, hereby freely, voluntarily and without duress execute this Agreement under the following terms:
Release and Waiver. In consideration of and in order to be allowed to participate in the Activities, I, the Volunteer, do hereby release and forever discharge and hold harmless the Released Parties and their successors and assigns from any and all liability, claims, demands, costs and damages of any kind, whether arising from tort, contract or otherwise, which I or my heirs, assigns, next of kin or legal representatives may have or which may hereinafter accrue, arise from, or are in any way related to my Activities with any of the Released Parties, including but not limited to personal injury, bodily injury, illness, property damage, loss or death, whether caused wholly or in part by the simple negligence, fault or other misconduct of any of the Released Parties or of other volunteers, other than their intentional or grossly negligent conduct.
I understand and acknowledge that by signing this Agreement I knowingly assume the risk of injury, harm, damage and loss associated with the Activities. I also understand that the Released Parties do 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, illness, death or property damage.
I understand and acknowledge that children under the age of 16 are not allowed on Habitat for Humanity worksites while construction is in progress. While minors between the ages of 16 and 18 may be allowed to participate in some types of construction work, I understand that using power tools, excavation, demolition, working on rooftops and similar activities are not permitted for anyone under the age of 18. I agree it is my responsibility to communicate these requirements to any of my minor children who will attend and/or participate in the Activities.
Assumption of Risk. I understand that I will be afforded every opportunity and should insist upon every opportunity to investigate and inspect the jobsite, facilities, and general condition of any location in which I may be present. I acknowledge that I will be afforded and should insist upon every opportunity to discuss the risks and harms, both generally and particular to the circumstances present, with the Released Parties or an agent thereof. I agree that I will ensure that any questions or concerns I have will be raised and adequately addressed before I engage in any Activity. I agree that my duty under this paragraph is continuing in nature throughout the course of my Activities. I agree to assume all risk and full responsibility for any risk of harm of any kind associated with the performance of any Activities or activities incidental thereto.
Indemnification. I further agree to indemnify and hold harmless the Released Parties to the full extent of any liability or financial or other responsibility arising out of or related in any way to the performance of any Activities or activities incidental thereto, including but not limited to personal injury claims, consortium claims, and property damage claims; whether such claim is brought by Volunteer or any third party. Such indemnification shall include all associated costs, including reasonable attorney fees incurred in preparing for or defending against any or all claims or causes of action contemplated or actually pursued, whether or not the action is actually filed, arising out of or in any way related to the performance of the Activities or activities incidental thereto.
Consent to Transportation and Medical Treatment. I consent to the use of first aid treatment and the use of generic and over the counter medications and treatments as directed by manufacturer labels, whether administered by the Released Parties or first aid personnel. In an emergency, I understand the Released Parties may try to contact the individual listed as an emergency contact. If an emergency contact cannot be reached promptly, I hereby authorize the Released Parties to act as an agent for me to consent to any examination, testing, x-rays, medical, dental or surgical treatment for me as advised by a physician, dentist or other health care provider. This includes, but is not limited to, my assessment, evaluation, medical care and treatment, anesthesia, hospitalization, or other health care treatment or procedure as advised by a physician, dentist or other health care provider. I also authorize the Released Parties to arrange for transportation of me as deemed necessary and appropriate in their discretion. I, the Volunteer, do hereby release, forever discharge and hold harmless the Released Parties from any liability, claim, demand, and action whatsoever brought by me or on my behalf which arises or may hereafter arise on account of any transportation, first aid, assessment, care, treatment, response or service rendered in connection with my Activities with any of the Released Parties.
If the Volunteer is less than 18 years of age, the parent(s) having legal custody and/or the legal guardian(s) of the Volunteer also hereby release, forever discharge and hold harmless the Released Parties from any liability, claim, demand and action whatsoever brought by such volunteer or on his/her behalf which arises or may hereafter arise on account of the decision by any representative or agent of the Released Parties to exercise the power to transport, administer first aid, and consent to assessment, examination, x-rays, medical, dental, surgical or other such health care treatment as set forth in the Parental Authorization for Treatment of, and Travel With, a Minor Child.
Insurance. I understand that, except as otherwise agreed to by the Released Parties in writing, the Released Parties are under no obligation to provide, carry or maintain health, medical, travel, disability or other insurance coverage for any Volunteer. Each Volunteer is expected and encouraged to obtain his or her own health, medical, travel, disability or other insurance coverage.
I understand that I am and remain responsible for payment of such hospital, physician, ambulance, dental, medical or other services obtained for me or my child. I agree that the Released Parties do not assume any responsibility for the payment of such fees or expenses which may be incurred. If I have health insurance, I understand my personal health insurance is my primary coverage.
Confidentiality. I agree that in the course of my participation in the Activities, I may have access to personal and/or health care information of other persons. I agree to maintain the confidentiality of such information, to use such information only as necessary to do my job as a volunteer, and to comply with Habitat for applicable policies regarding such information.
Photographic/Recording Release and Consent. I hereby grant and convey unto Habitat for Humanity International, Inc. all right, title and interest in any and all photographs and video/audio/electronic recordings of me, including as to my name, image and voice, made by or on behalf of any of the Released Parties during my Activities with the Released Parties, including, but not limited to, the right to use such materials for any purpose and to any royalties, proceeds or other benefits derived from them. I understand that I will not have any ownership interest in or to such photographs, images and/or recordings, I have not been provided or promised any compensation to me, and I hereby waive any rights, privileges or claims based on any right of publicity, privacy, ownership or any other rights arising, relating to or resulting from the photographs, images and/or recordings. I understand and agree that this paragraph also applies to my minor child(ren) who are volunteering.
Other. I expressly agree that this Agreement is intended to be as broad and inclusive as permitted by applicable law. I further agree that in the event any clause or provision of this Agreement is held invalid by any court of competent jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining clauses or provisions of this Agreement, which shall continue to be enforceable. Further, a waiver of a right under this Agreement by a Released Party does not prevent the exercise of any other right.
I have carefully considered my decision, the benefits and risks involved and hereby give my informed consent to participate in all volunteer Activities. I have read and understand this Agreement, any questions of mine have been answered, and I voluntarily agree to the above provisions. It is my intent to bind my heirs, next of kin, assigns, beneficiaries and legal representative.
Check here to show you accept the terms stated above for yourself or for a minor volunteer for which you are a parental guardian.
