In the event of a medical emergency, by checking "yes" and signing this form I confirm that I consent to the necessary and proper treatment, surgery and/or anesthetic by a licensed physician or health care professional for the individual named on this form.

By checking "yes" and signing this form, I give Friends of Refugees, Inc., permission to photograph me and use such photos in Friends of Refugees, Inc., promotional materials and related publications without renumeration to me.

By checking "agree" and signing this form, I confirm that I am aware of the potential risks to myself during my volunteer assignment with Friends of Refugees, Inc. With such knowledge, I hereby assume full and complete responsibility for any personal injury and/or property damage that I sustain or cause during my participation as a volunteer. In addition, I hereby release, hold harmless, and covenant not to file suit against Friends of Refugees, Inc., its affiliates, and any of their employees, volunteers, partners, agents, sponsors, board members, and successors from any and all loss, liability, or claims I may have arising out of my service as a volunteer.

By checking "Agree" and signing this form, I agree to the following: • I agree that I will be operating as a volunteer for Friends of Refugees, Inc. • I do not expect an renumeration for my services. I understand that I may be reimbursed for some incidental expenses. • I understand this is an application and not a commitment or promise of volunteer opportunity. • I certify that my answers are true and complete to the best of my knowledge and have not nor will not withhold information that will unfavorably affect my application for a volunteer position. • If this application leads to a volunteer position with FOR, I understand that false or misleading information in my application or interview may result in my release.• I authorize my current or previous employers, schools or persons listed to give any information necessary to process this application. I herby release employers, schools or persons from all liability should a volunteer position be withdrawn or terminated as a result of statements made in reference to this application. • I have been notified that a background check will be requested and used for the purpose of evaluating me as a volunteer or intern. I give Friends of Refugees permission to conduct background checks necessary to process this application. • I understand that Friends of Refugees is an “at will” company, which means that either I or Friends of Refugees can terminate the volunteer relationship at any time, with or without prior notice, and for any reason not prohibited by statute.

I understand that I may be asked to drive refugees in the course of my volunteer service with Friends of Refugees. At that time, I will provide a copy of my driver’s license and verification of insurance to the program director I am volunteering under. If I drive clients in my own car, I understand that expenses will be reimbursed at the program director’s discretion and must be approved ahead of time, and that my personal insurance is the primary liability protection and must be issued by a company authorized to do business in my state of residence. Also, by checking above and signing below, I agree:• I have had a valid driver’s license or permit for the past three years.• I have had no at-fault vehicle accidents, moving traffic violations, DUIs, speeding tickets over 20mph or tickets for reckless/negligent driving in the past three years.• My vehicle is mechanically sound and is equipped with seat belts which I will use and enforce use by my passengers. • Children age 12 & under will be placed in the rear of the vehicle & child restraints (car seat – backward facing, up to 20lbs; booster seat – forward facing, until child is 4’ 9” tall) will be properly used.By checking above and signing below, I certify that I have provided the information above, and it is true and correct to the best of my knowledge. I also agree to promptly notify my supervisor of any traffic citations I receive or of any involvement in an accident – even if given while driving on my personal time.

I understand that Friends of Refugees, Inc. may for any reason, accept or reject me as a volunteer, and at any time if I am accepted as a volunteer, for any reason terminate my service as a volunteer with Friends of Refugees, Inc. I agree that any claim or dispute arising from or related to my work as a volunteer for Friends of Refugees, Inc. or my application as a volunteer for that work shall be settled by mediation and, if necessary, legally binding arbitration in accordance with Georgia law and under the guidelines and rules of the American Arbitration Association. Judgment upon an arbitration decision may be entered in any court otherwise having jurisdiction. The parties understand that these methods shall be the sole remedy for any controversy or claim arising out of this agreement and expressly waive their right to file a lawsuit in any civil court against one another for such disputes, except to enforce an arbitration decision. I hereby waive trial by jury in any action or proceeding arriving out of or in any way pertaining to this agreement. I agree and understand that this waiver constitutes a waiver of trial by jury of all claims against all parties to such actions or proceedings, including claims against parties or not parties to this agreement. This waiver is knowingly, willingly and voluntarily made and no representations of fact or opinion have been made by any individual or entity to induce this waiver of trial by jury.