Office Use Only:
Start Date: _________________________
Thank you for your interest in Habitat for Humanity Peterborough and District. The
information that you provide will help us to place you in a position that best suits your skills,
needs and the needs of our organization.
Surname:_________________________________ Given name: _____________________________
Street Address: _____________________________________________________________________
City: _________________________________ Postal Code: _________________________
Phone: (home) __________________ (work) ____________________ (fax) _______________
Email: _________________________________ Occupation: __________________________
Availability during the week (please check when you can volunteer):
Monday Tuesday Wednesday Thursday Friday Saturday
Areas of Interest/Skills: (Please check)
General Labour Volunteer: Assists the ReStore in a number of areas such as the loading
and unloading of dock area, movement of large appliances, maintaining the back storage area.
Also assists in managing the trim and storage trailers, outside maintenance of the grounds and
pickups and deliveries.
Retail Support Volunteer: Assists in the marketing, pricing, organizing and display of
product, stocking of shelves, cleaning of display areas and ensures that the donated retail
product protocol is followed.
Administrative Support Volunteers: Assists in the administrative duties of the ReStore and
Affiliate such as data input, filing, record keeping, correspondence, volunteer database, retail
store donations, and customer services.
Marketing/Communications Support Volunteer: Assists the ReStore in preparation and
implementation of a Marketing Plan. This will include work around strategic advertising,
special events, trade shows, press releases, video production, website update and
maintenance, e-bay connection, coupon strategy and linkage to other non-profit groups and
other partnerships, brochure and poster productions.
Technical Support Volunteer: Assists in the testing of large and small appliances, light
fixtures, power tools, undertakes general repairs, assembles items such as cabinets and assists
in loading and unloading in dock area.
It Support Volunteer: Assists in the testing and fixing of computers and related items for
ReStore sale, assisting in any ReStore computer applications such as the web site, volunteer
database, tracking and receiving donations.
Special Projects Volunteer: Assists the ReStore with special events throughout the year
such as the Alcan Project, ReStore events, clean-up projects, staff and volunteer events, trade
shows, fundraising events, Youth Programs, etc.
Salvage Crew Volunteer: Acts as a member of the ReStore Salvage Crew in the removal of
saleable products from homes, cottages and businesses in the Peterborough and district for
resale at the ReStore.
Do you have any medical condition and or physical disability that you wish to be taken into
consideration, or that you feel may affect your ability to perform as a volunteer?
We look forward to providing you with more details about Habitat for Humanity and our
great team of volunteers. You will be placed on our mailing list for our newsletter. Please keep
us updated if you change your address or phone number.
RELEASE AND WAIVER OF LIABILITY
RELEASE AND WAIVER OF LIABILITY (the “Release”) signed on ______________ by ____________________________ (the “Volunteer”) in
favour of HABITAT FOR HUMANITY PETERBOROUGH AND DISTRICT, a Canadian non-profit corporation and its directors, officers,
employees, and agents (collectively, “Habitat”).
The volunteer desires to participate in Habitat for Humanity’s ReStore activities. The volunteer does hereby freely, voluntarily, and without duress
execute this release under the following terms:
WAIVER AND RELEASE: The volunteer does hereby release and forever discharge and hold harmless Habitat for Humanity Peterborough and
District and their successors and assigns from any and all liability, claims, and demands of whatever kind or nature, either in law or in equity, which
arise or may hereafter arise from the volunteer’s participation in volunteer work at Habitat for Humanity’s ReStore.
The volunteer understands that this release discharges Habitat for Humanity from any liability or claim that the volunteer may have against Habitat
for Humanity with respect to any bodily injury, personal injury, illness, death or property damage that may result from the volunteer’s participation in
volunteer work at Habitat for Humanity’s ReStore. The volunteer also understands that Habitat for Humanity does not assume any responsibility for
or obligation to provide financial assistance or other assistance, including but not limited to medical, health or disability insurance.
MEDICAL TREATMENT: The volunteer does hereby release and forever discharge Habitat for Humanity from any claim whatsoever which arises
or may hereafter arise on account of any first aid, treatment, or service rendered in connection with the volunteer’s participation in volunteer work at
Habitat for Humanity’sRestore. The volunteer understands that s/he is responsible for securing appropriate medical insurance coverage.
ASSUMPTION OF RISK: The volunteer understands that the Habitat for Humanity
building project may include activities that may be hazardous to the volunteer and that the food, accommodations, and medical facilities may be
donated to Habitat for Humanity and beyond the control of Habitat for Humanity.
The volunteer hereby expressly and specifically assumes the risk or harm in their activities and releases Habitat for Humanity from all liability from
injury, illness, death or property damage resulting from the activities of the volunteer’s participation in volunteer work at Habitat for Humanity’s
Habitat for Humanity retains the right to limit or prohibit participation of the volunteer in the activities of the ReStore if Habitat for Humanity
determines that such participation will not be in the best interests of Habitat for Humanity or the volunteer. The volunteer understands that s/he will
be responsible for the payment of any expenses incurred as a result of application of this section.
PHOTOGRAPHIC RELEASES: The volunteer does herby grant and convey unto Habitat for Humanity all right, title, and interest in any and all
photographic images and video or audio recordings made by Habitat for Humanity.
OTHER: The volunteer expressly agrees that this Release is intended to be as broad and inclusive as permitted by the laws of the country of Canada,
and that this release shall be governed by and be interpreted in accordance with the laws of the country of Canada. The volunteer agrees that in the
event that any clause or provision of this release shall be held to be invalid by any court of competent jurisdiction, the invalidity of such a clause or
provision shall not otherwise affect the remaining provision of this Release which shall continue to be enforceable.
IN WITNESS WHEREOF, the volunteer has executed this Release as of the day and year first above written.
VOLUNTEER: Please print name _____________________________________________ Date ___________________
Signature of Volunteer or Parent/Guardian if under the age of 18. (Volunteers under age 16 may not participate in Habitat for Humanity
WITNESS: _____________________________________ _________________________________________
Please print Signature
Emergency contact _________________________________ Relationship _______________________________
Phone (Home) _______________________ (Celll) ______________________ (Work) _________________________
Habitat for Humanity Peterborough and District respects your privacy. We protect your personal information and adhere to all legislative