Thank you so much for choosing to help with service projects at the Family Care Network. Please take a moment to review the volunteer agreement and Oath of Confidentiality below and then fill out your information to sign the agreements.
As a volunteer group with The Family Care Network, Inc. (FCNI), there are expectations for your group in order to provide a safe and healthy environment in all situations for our FCNI Families. I agree to work as a volunteer for the Family Care Network. As a member of a volunteer group, I agree to follow these basic guidelines and ground rules.
1. No smoking or drinking- As a volunteer of FCNI, I will refrain from smoking or drinking of alcohol during the time I have set aside to help a FCNI Family.
2. I also understand that I will not be compensated for any time spent volunteering, nor am I entitled to benefits, including employment insurance benefits upon the termination of this agreement or as a result of this service.
3. I am aware that participation as a volunteer could require periods of physical requirements, i.e. standing, lifting and carrying up to 40 pounds and will require the exercise of reasonable care to avoid injury. I am voluntarily participating in this activity with knowledge of the hazards and potential dangers involved, and agree to accept any and all risks of personal injury and property damage.
4. FCNI will not make a claim against or sue me for any injury or damage resulting from any work I perform as a volunteer and I am making no assertions about the quality or acceptability of the work I perform as a volunteer.
5. Contact with FCNI Family- I agree to not call the FCNI Family, unless I am the Volunteer Group Point of Contact. I agree not to take any member of the FCNI Family to my place of residence.
6. I understand that if I am injured in the course of the project, I am not covered by the Family Care Network, Inc.’s workers’ compensation program. I authorize Family Care Network, Inc. to seek emergency medical treatment on my behalf in case of injury, accident or illness to me arising from my involvement as a volunteer. I understand that I will be responsible for medical costs incurred by such accident, illness or injury.
7. Confidential Information- I agree to not share confidential information with anyone outside of the volunteer group. Confidential information includes, but is not limited to: FCNI Family’s phone number, home address, email address, family’s last name, individual family member’s names, parent’s employer, family dynamic or concerns.
8. I agree to not evangelize or share my personal beliefs with the FCNI Family, unless a family member asks me about my faith or personal beliefs. I also agree to not invite the family to any social or religious activities or events, unless the family member initiates interest in the activity/event.
9. Pictures: I agree to not take pictures of the FCNI Family during any of the projects. I understand that the only person who can take a picture is the Volunteer Group Point of Contact, and that they must have the approval of the FCNI Family and Volunteer Coordinator before using the picture in any way.
10. I understand that FCNI may modify or terminate this agreement without cause at any time.
Oath of Confidentiality
I, the undersigned, hereby agree not to divulge or misuse any confidential information or records controlled by statute, including criminal record information, concerning any agency employee, volunteer, or client without proper authorization in accordance with California Penal Code Sections: 502, 11105, 13300, 11140-11144, 13301-13305; and California Welfare and Institutions Code, Section 5328, et seq.
I recognize the unauthorized release of confidential information may make me subject to a criminal action under provisions of the Penal and/or Welfare and Institutions Code.
Penal Code, Section 11142: Any person authorized by law to receive a record or information obtained from a record who knowingly furnishes the record or information to a person who is not authorized by law to receive the record of information is guilty of a misdemeanor.
W & I Code, Section 5330: Any person may bring an action against an individual who has willfully and knowingly released confidential information or records concerning the person in violation of the provisions of this chapter, for the greater of the following amounts:
- Five hundred dollars ($500).
- Three times the amount of actual damages, if any sustained by the plaintiff.
Any person may, in accordance with the provisions of Chapter 3 (commencing with Section 525) of Title 7 of Part 2 of the Code of Civil Procedure, bring an action to enjoin the release of confidential information or records in violation of the provisions of this chapter, and may in the same action seek damages as provided in this section.
It is not a prerequisite to an action under this section that the plaintiff suffers or be threatened with actual damages.
I understand that to knowingly furnish any confidential criminal record or client information to a person not legally entitled to the same is a misdemeanor punishable by state law; and any such misuse may result in immediate dismissal from the Family Care Network, Inc.
Please fill out the fields below to complete your volunteer agreement.