Fields marked with an asterisk (*) are required.
AmeriCorps Seniors programs are federal National Service programs are for volunteers 55 years of age or older.
Section
This is used for maintaining the records for program research or survey response, and in the production of summary descriptive statistics and analytical studies.
Please select the category or categories with which you most closely identify.
Veteran Status
As an RSVP volunteer, you are insured for supplemental volunteer accident and personal liability while volunteering at a volunteer site. This is strictly secondary insurance at NO COST to you. Since there is a small accidental death benefit involved, you are asked to name a beneficiary.
Beneficiary Information for AmeriCorps Seniors RSVP Supplemental Insurance:
I understand, (excluding the supplemental volunteer accident insurance provided), that my activities as a volunteer for HandsOn Central California (HOCC) are undertaken at my sole risk, and HOCC will not be liable for any claims for injuries or damages whatsoever to my person or property arising out of or connected with my actions as a RSVP volunteer. I agree to indemnify and to hold harmless HOCC for all cliams and/or liability for me or to me. I also agree that this waiver and release shall apply to my heir(s), executor(s), and administrator(s).
I understand that by agreeing to this waiver, I give permission to use my image in educational and/or public relations materials.
I volunteer my services through the HandsOnCentral California AmeriCorps Seniors RSVP Program, and I undrstand that I will be placed in a volunteer position, not a paying job. My volunteering is at my discretion and does not interfere with job search or employment.
I have carefully read this Waiver/Release, I understand its contents, and I intend to be bound by its terms.