I wish to volunteer my time and services with the Poor Handmaids of Jesus Christ Volunteer Program hereby acknowledge that said organization is doing everything they can to protect the public and myself as a volunteer. To this extent, I agree to follow Center of Disease Control (CDC), local health district guidelines and Poor Handmaids of Jesus Christ Volunteer Program policies and procedures for social distancing to reduce the spread of Novel Coronavirus, or COVID-19. This will require me to maintain six (6) feet of distance between myself, fellow volunteers, and patrons of the organization as much as possible. This procedure will be required for visitor-to-visitor contact as well to limit exposure.

I agree to utilize surgical or improvised masks to reduce the risk of exposure to myself and others. I agree to wash or sanitize my hands after using the restroom, sneezing, and coughing, and before eating or preparing meals or sundries for distribution, and will properly wear and utilize sterile gloves.

I understand that I may be informed of or encounter sensitive Personal Health Information (PHI) for those that the Poor Handmaids of Jesus Christ Volunteer Program serves. I agree to hold this information in confidence and will not disseminate any PHI except as allowed by law and/or per the policy and procedures of said organization for which I am volunteering.

I understand that there is no direct medical health coverage afforded to me during my relationship with the Poor Handmaids of Jesus Christ Volunteer Program and that it is not responsible for any potential exposure to Novel Coronavirus, or COVID-19, which is not a direct result of negligence on the part of their employees, volunteers, or the organization.

By signing below, I agree to comply with the written instructions above. Failure to comply with these written instructions or verbal instructions from staff may result in my volunteer privileges being removed and I may be asked to leave the premises.

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