Volunteer Application and Release Form - Innes CLC
(Volunteers must be at least 18 years of age.  This form will be shared with the school you choose to serve. A separate form must be completed for each school you wish to serve)
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Email *
Date
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First Name *
Last Name *
Date of Birth *
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Gender *
Driver License Number *
Driver License Issuing State *
Address *
Primary Phone *
Name of Employer *
Education (Highest Level) *
Areas in which you are interested in offering volunteer services: *
School of interest. *
All volunteers should sign-in at the school office upon entering the building.
Required
Please check your availability for volunteering:
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Morning
Afternoon
Evening
Please give the name and phone number of someone who may be contacted in case of an emergency: *
Akron Public Schools Bylaws and Policies (Follow this link to Section 3120.09 and 4120.09 for Board Volunteer Policy)
Volunteer Agreement
As a volunteer, I agree to abide by all relevant Board policies and administrative guidelines while on duty for the District. I understand that as a volunteer, I am prohibited from accepting compensation from any third party or source, including, but not limited to booster, parent or other District support organizations, for the performance of my duties as a volunteer on behalf of the District.  I understand that, although I am covered under the District'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 District, I agree that I shall be responsible for any and all hospital and medical charges that may accrue. I understand further that, as a volunteer, I am not in any manner considered an employee of the District or entitled to any benefits provided to employees.
I further release the Akron Board of Education from any and all liability for any damages, whatever their nature, which may result as a consequence of my volunteer services. I understand that all volunteers need to display appropriate behavior at all times. In accordance with R.C. 109.575, I may be required to provide a set of fingerprints at any time so that a criminal records check can be conducted. If a criminal records check is conducted, it will be done as a condition of my initial or continued service as a volunteer. If a criminal records check indicates that a volunteer has been convicted of or pleaded guilty to any of the offenses described in R.C.109.572(A)(1), the volunteer will be informed of the Board's actions in accordance with Board Policies 3120.09 and 4120.09.
DUTY TO MAINTAIN CONFIDENTIALITY OF STUDENT RECORDS AND INFORMATION
The District is committed to maintaining the security and confidentiality of all student records and/or student personally identifiable information. As a volunteer in the District, I may have access to student records and/or student personally identifiable information that must be maintained as confidential and not released and/or permitted access to except as authorized by Board policy and law. Violations of this duty may result in a reassignment and/or restriction of my volunteer responsibilities by the building principal or designee. As a volunteer I agree to comply with the following: To treat any and all student records confidential and not place any student information where they may be viewed by others. I agree not to discuss or repeat information overheard while in the staff lounge, classrooms, offices, school grounds, hallways, school or extra-curricular activities. I understand that I may not discuss information obtained while in a classroom, such as a student's grade or behavior, with anyone other than the student's teacher or the building principal. I agree to bring any concerns or questions regarding student records or issues of confidentiality to the attention of the building principal. I also agree that if I have any knowledge of a violation of these provisions I will immediately report the violation to the building principal.



BY ENTERING MY NAME BELOW I HEREBY CERTIFY THAT THE INFORMATION I PROVIDED TO THE DISTRICT IN THIS APPLICATION AND RELEASE IS TRUE. I FULLY ACKNOWLEDGE THAT I HAVE READ AND UNDERSTOOD AND AGREE TO COMPLY WITH THE TERMS AND CONDITIONS SET FORTH IN THIS VOLUNTEER APPLICATION AND RELEASE FORM AND AGREE TO BE BOUND BY ALL APPLICABLE BOARD POLICIES, INCLUDING BUT NOT LIMITED TO BOARD POLICIES 3120.09 AND 4120.09. BY ENTERING MY NAME, I FURTHER AFFIRM THAT I HAVE NEVER BEEN CONVICTED OF ANY OFFENSE LISTED IN BOARD POLICIES 3120.09, 4120.09 AND/OR DESCRIBED IN OHIO REVISED CODE 109.572(A)(1) AND AGREE THAT I MAY BE SUBJECTED TO A CRIMINAL BACKGROUND CHECK AT ANY TIME. *
Required
Volunteer Signature (Full Name) *
I hereby give permission for Akron Public Schools to use my name, likeness and speech in any photograph or video made during my volunteer service, for any business purpose during the school year, as indicated by submitting this registration. *
By submitting this form, I authorize Akron Public Schools to verify,  obtain copies of records, and gather information pertaining to this volunteer registration. *
Required
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