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Mineral County School District
Volunteer Agreement Form
11/15/2019
School:
School Year:
NAME: *
E-MAIL:
ADDRESS: *
HOME PHONE: ()- Ext.
CELL PHONE: ()- Ext.


 

I have offered my services as a volunteer to help the Board of Education.

If you are the parent/guardian of a student enrolled in this school, please list name of student.  

If you are volunteering as a non-coach for a sport, please list the sport.  

Please check if you are volunteering for band activities.  


 

I agree to abide by all relevant Board policies and administrative guidelines while on duty for the Board or school to which I am assigned.  I understand that, although I am covered under the Board's liability insurance policy, I am not covered by its health insurance policy nor am I eligible for workers' compensation.  Should I become ill or suffer an accident while doing volunteer work for the Board, I agree that I shall be responsible for any and all hospital and medical charges that may occur.

I understand further that, as a volunteer, I am not in any manner considered an employee of the Board or entitled to any benefits provided to employees.  I further release the Board from any and all liability for any damages, whatever their nature, which may result as a consequence of my volunteer services.

All volunteers need to display appropriate behavior at all times.  Confidentiality of all school, staff, and student matters is expected.


 

1. Is any action now pending against you for alleged misconduct toward a minor in any school district, court or other employment?
*
Yes  No  
2. Have you ever been charged with, or convicted of, or under indictment for a felony?
*
Yes  No  
3. Have you ever been charged with, or convicted of, a misdemeanor? (For the purpose of this agreement, minor traffic violations should not be reported.)
*
Yes  No  
4. Do you have any prior arrests or convictions of any offense(s) that involve misconduct toward a minor? 
*
Yes  No  


If you answer yes to any of the questions, full written disclosure and documentation must be provided to the school principal and the Director of Human Resources prior to approval.


 

I acknowledge that by clicking on the "Submit" button, I am indicating my intent to sign the relevant document and that this shall constitute my signature.


 

PRINCIPAL'S SECTION:
  

I have approved the above volunteer, and have verified that the volunteer's name does not appear on the sexual offender registry.

https://apps.wv.gov/StatePolice/SexOffender/Disclaimer?continueToUrl=http%3A%2F%2Fapps.wv.gov%2FStatePolice%2FSexOffender
Yes  No  
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