1. Release and Waiver of Liability
We greatly appreciate your assistance and commitment to supporting employment, education, housing and transportation for at-risk youth, adults, and Veterans with disabilities. Our policies require that we have an accurate record of all volunteers. This is a form in which you agree to release U&I of all liability while working as a volunteer for our organization.
This Release and Waiver of Liability (the “Release”) as of the date of the checked box below, by the “Volunteer”, whose name appears on the Volunteer form, releases U&I, their directors, officers, employees, and agents. The Volunteer desires to provide volunteer services for U&I and engage in activities related to serving as a volunteer.
Volunteer understands that the scope of Volunteer’s relationship with U&I is limited to a volunteer position and that no compensation is expected in return for services provided by Volunteer; that U&I will not provide any benefits traditionally associated with employment to Volunteer; and that Volunteer is responsible for his/her own insurance coverage in the event of personal injury or illness as a result of Volunteer’s services to U&I.
1. Volunteer Code of Conduct and Ethics: U&I expects volunteers to follow rules of conduct that will protect the interests and safety of all volunteers, clients, client families, employees and the organization. As a U&I Volunteer, I am expected to maintain a positive atmosphere by acting and communicating in a manner that demonstrates respect, values input, acknowledges contributions and embraces diversity & inclusion. In performing any service for U&I, I agree to meet the following standards of conduct:
- Treat all individuals with respect, patience, integrity, courtesy, dignity and consideration.
- Represent U&I in an appropriate and professional manner at all times.
- Be reliable and follow through on volunteer commitments.
- Respect any/all confidential information.
- Communicate to U&I staff about any resources or support needed to fulfill the volunteer role.
- Keep safety as a top priority.
- Not use, possess or be under the influence of illegal drugs or alcohol while serving in a volunteer capacity.
- Avoid conflict of interest situations and refrain from actions that may be perceived as such.
- Not engage in conduct that threatens, intimidates or coerces another person, including all acts of harassment that is based on an individual’s race, color, religion, sex, national origin, age, sexual orientation, gender identity, transgender status, disability, veteran status, genetic information, or other protected status.
- Participate in orientation and any required training that will equip them to complete their volunteer roles.
- Provide their own transportation and cover expenses related to volunteering for U&I, unless otherwise stated and approved prior to incurring the expense.
- Dress in a manner that is appropriate for a given program/event in accordance with that program/event’s dress code.
- Abide by all applicable laws and U&I volunteer program policies, guidelines and procedures.
2. Waiver and Release: I, the Volunteer, release and forever discharge and hold harmless U&I and its successors and assigns from any and all liability, claims, and demands of whatever kind of nature, either in law or in equity, which arise or may hereafter arise from the services I provide to U&I. I, for myself, my heirs, executors and administrators, hereby agree to indemnify and hold harmless to U&I. I understand and acknowledge that this Release discharges U&I from any liability or claim that I may have against U&I with respect to bodily injury,personal injury, illness, death, or property damage that may result from the services I provide to U&I or occurring while I am providing volunteer services.
3. Insurance: Further I understand that U&I does not assume any responsibility for or obligation to provide me with financial or other assistance, including but not limited to medical, health, or disability benefits or insurance. I expressly waive any such claim for compensation or liability on the part of U&I beyond what may be offered freely by U&I in the event of injury or medical expenses incurred by me.
4. Assumption of Risk: I understand that the services I provide to U&I may include physical activities that may result in injury to me. I acknowledge that I am physically fit and able to safely participate in the volunteer activities without risk to myself or others. As a volunteer, I hereby expressly assume risk of injury or harm from these activities and Release U&I from all liability.
5. Background Checking: I understand that various volunteer positions require background check(s). If required, I hereby authorize U&I to run such background checks and also agree to provide proof of licensure or certification prior to performing any professional or skilled task. By signing this waiver, whether physically or by digital verification, I certify that the information contained in this application is correct and true. If U&I, determines that any information submitted is false, I may be immediately disqualified from consideration for volunteering and/or discharged from volunteer service.
6. Photographic Release: I grant and convey to U&I all right, title, and interests in any and all photographs, images, video, or audio recordings of me or my likeness or voice made by U&I in connection with my providing volunteer services to U&I.
7. Other: As a volunteer, I expressly agree that this Release is intended to be as broad and inclusive as permitted by the laws of the State of Texas and that this Release shall be governed by and interpreted in accordance with the laws of the State of Texas. I agree that in the event that any clause or provision of this Release is deemed invalid, the enforceability of the remaining provisions of this Release shall not be affected.
8. Change in circumstances: I understand that if there is a change in my circumstances or condition, I must notify U&I before my next volunteer shift.
9. Donation Handling: I recognize that donors provide financial and other resources to U&I for support of the mission of U&I. If/When handling U&I donations, I will do so with integrity and honesty and in accordance with U&I’s policies and guidelines.
By checking below, I express my understanding and intent to enter into this Release and Waiver of Liability willingly and voluntarily.
2. Misconduct Registry Information
The Employee Misconduct Registry is maintained by the Texas Department of Aging and Disability Services (DADS) and was implemented to track substantiated findings of resident and client abuse, neglect, exploitation, and misappropriation committed by unlicensed or non-credentialed direct care employees that work in HHSC-licensed and regulated long term care facilities or who work with HCS, TxHL or CLASS clients. This Registry was created in accordance with the provisions of Senate Bill 967 and Chapter 253 of the Health and Safety Code.
If DADS receives a report that an employee of a facility has abused, neglected, or exploited a resident or client of a facility or misappropriated a resident or client’s property, DADS will conduct an investigation of the report. If, after its investigation, DADS makes a preliminary determination that the employee did abuse, neglect, or exploit a facility resident or client or that the employee did misappropriate the property of a client or resident, the following procedures will be followed:
- The employee will be provided with written notice of the preliminary findings.
- The employee will be provided with notification of his/her right to an informal reconsideration.
- If the employee does not respond to the notice of the informal reconsideration opportunity or if the informal reconsideration results in a finding of abuse, neglect, exploitation, or misappropriation, DADS will give the employee written notice of its findings.
- The employee will also be provided with notice of his/her right to a hearing.
- The commissioner or his designee will issue an order approving the determination and ordering that the incident of misconduct be recorded in the registry under the Texas Health and Safety Code, 253.007 if:
- the employee fails to respond to the notice
- the employee accepts DADS’ determination
- the hearing examiner finds that the employee abused, neglected, or exploited a client or resident or misappropriated the property of a client or resident.
- The employee will be provided with written notification of the order as well as notice of his/her right to a judicial review of the order.
- The incident of misconduct will be recorded in the registry if the employee does not request judicial review of the determination or if the court sustains the determination.
The following information will be included in the registry:
- the employee’s name and address;
- the employee’s social security number;
- the name and address of the facility;
- the date of the act of misconduct; and
- a description of the act of misconduct.
Achieve will check the Employee Misconduct Registry and the Nurse Aide Registry for all applicants. Achieve is prohibited from employing any individual whose name is in either of these Registries.
I acknowledge that I have received written notification about the employee misconduct registry and that Achieve may not hire any employee listed on the Employee Misconduct or Nurse Aide Registries.
3. Emergency Information
This information is required to ensure your safety in the event of an emergency while volunteering or participating as an intern. Please provide accurate and up-to-date emergency contact and medical information. All information will be kept confidential and used only in case of an emergency.
4. Background Verification Release Form
I hereby authorize Citizens Development Center dba U & I to request and receive any and all background information about or concerning me, including but not limited to my Criminal History, Credit History including a consumer report under the Fair Credit Reporting Act, 15 U.S.C 1681, Driving Record, Employment History, Military Background, Civil Listings, Educational Background, Professional License from any Individual, Corporation, Partnership, Law Enforcement Agency, and other entities including my Present and Past Employers.
The criminal history, as received from the reporting agencies, may include arrest and conviction data as well as plea bargains and deferred adjudications and delinquent conduct as committed as a juvenile. I understand that this information will be used, in part, to determine my eligibility for an employment/volunteer position with this organization. I also understand that as long as I remain an employee or volunteer here, the criminal history check may be repeated at any time. I understand that I will have an opportunity to review the criminal history as received by client/agency and a procedure is available for clarification, if I dispute the record as received. I also understand that the criminal history could contain information presumed to be expunged.
I further release and discharge Citizens Development Center dba U & I and their Service Provider and all of their Subsidiaries, Affiliates, Officers, Employees, Contract Personnel, or Associates, from any and all claims and liability arising out of any request for information or records pursuant to this authorization, procurement of an investigative consumer report and understand that it may contain information about my character, general reputation, personal characteristics, and mode of living, whichever are applicable.
I understand that I have the right to make written request within a reasonable period of time to VeriFYI for additional information concerning the nature and scope of the investigation. I acknowledge that I have voluntarily provided the above information for employment/volunteer purposes, and I have carefully read and understand this authorization.
5. Volunteer/Intern Application
Our volunteer and internship opportunities are designed to provide hands-on experience, skill development, and exposure to real-world projects while contributing to our mission. Whether you are a student, recent graduate, or someone looking to gain practical experience, we welcome your application.
Please complete the application form below with accurate and detailed information. This will help us understand your background, interests, and how you can best contribute to our team. Our team will review your application and contact shortlisted candidates for the next steps.
