I desire to work as a volunteer for the Humboldt Housing and Homeless Coalition (HHHC) during the 2022 Point-in-Time Count.
I understand that the scope of my relationship with the HHHC is limited to a volunteer position, that I will not receive employee compensation from the HHHC and that I will not have nor will I acquire any employee rights or employee benefits of any kind from the HHHC.
I understand that my participation as a volunteer and the use of County facilities is voluntary and is not being done at the direction of any County elected official, officer, employee, or agent.
I have been informed and recognize that my services as a volunteer may require physical activity. I have been informed that before beginning any program of physical activity, I should have a thorough physical examination by a physician who has been informed of my proposed participation as a volunteer and who is completely aware of my physical condition.
I acknowledge that I fully understand my services as a volunteer may involve risk of serious injury, death, or property damage, including losses which may result not only from my own actions, inactions or negligence, but also from the actions, inactions, or negligence of others, or the condition of the facilities, equipment, or areas where my services as a volunteer are being rendered.
Knowing and understanding the risks involved with my services as a volunteer, I hereby voluntarily and willingly assume responsibility for all risks and dangers associated with my service as a volunteer except as expressly stated in this Release.
I understand that the HHHC, its elected officials, officers, employees, agents, and other volunteers ("Releasees") do not assume any responsibility for or obligation to provide me with financial or other assistance, including but not limited to worker's compensation, medical health or disability benefits or insurance. I expressly waive any claim for compensation or liability of any kind on the part of the Releasees.
I hereby release, discharge, hold harmless, and agree not to sue, and to indemnify Releasees from any and all demands, actions, suits, and claims which I have or that might accrue to me and from any and all damages which may be sustained by me or for any injury, death, or damage to or loss of personal property arising out of, or in connection with, my participation in the Activity from whatever cause, including the active or passive negligence of Releasees or any other participants in the Activity.
I have carefully read this Release and understand its contents. I am aware that this Release is a release of liability and voluntarily execute it. My signature on this document is intended to bind not only myself, but also my heirs, administrators, executors, and assigns. The undersigned expressly agrees that this Release is intended to be as broad and inclusive as permitted by California law.
As a volunteer with the Point-in-time count, you will encounter community
members that are homeless, have an illness, or are experiencing
challenging times in their life. Some may complete the survey with little
interaction while some may share their entire life story with you.
Respecting the privacy of our community member, staff, and volunteers is a
priority for the Humboldt Housing and Homeless Coalition (HHHC).
Personal, health and financial information is confidential and should not be
disclosed or discussed with anyone. Care shall also be taken to ensure that
unauthorized individuals do not overhear any discussion of confidential
information and that documents containing confidential information are not
left in the open or inadvertently shared.
Staff and volunteers will be exposed to information which is confidential in
nature. It is the policy of the HHHC that such information must be kept
confidential both during and after volunteer service. Staff and volunteers
are expected to return any paper surveys at the end of your shift.
As a volunteer for the PIT count, it is prohibited to: