House Volunteer Application Form (Page 2 of 2) in pdf

Please select the days and times that you are available to volunteer at our

Ronald McDonald House in numerical priority.

Shifts

Monday

Tuesday

Wed.

Thursday

Friday

Saturday

Sunday

9am-12pm

12-3pm

3-6pm

6-9pm

Volunteering with us entails being assigned to a specific, weekly three hour

shift that you will commit to after orientation. For example, you may be

asked to take the Wednesday 3-6pm shift if that is one of your choices.

Then it would be yours to work each week, and we ask you to commit to

volunteering with us for a minimum of at least six months if at all possible.

Please give two personal references:

1. Name ____________________________

Phone # ___________________

2. Name ____________________________

Phone # ___________________

In case of emergency (required):

Contact name: _____________________________________________________

Relationship_______________________ Phone Number____________________

Please add any additional information you feel is relevant to your application:

__________________________________________________________________

By signing below, I certify that the information I have provided on this application is true to the best of my

knowledge and agree to respect the families’ right to confidentiality during and after my time at Ronald

McDonald House Charities of Austin & Central Texas.

I also understand and agree on behalf of all such persons that RMHC, its staff, board of trustees,

volunteers and others associated with RMHC or the Family Rooms will not be responsible or liable under

any theory of liability for any claims, losses, damages or injuries of any kind or nature, including, without

limitation, any loss of or damage to our valuables, or other personal property from any cause, including

the RMH’s negligence, and/or for any personal injuries, illness, or death to us (or any of us) from any

cause, including RMHC’s negligence.

I hereby grant to RMHC and its local chapters and programs the irrevocable, unrestricted right to use,

publish, display or distribute materials bearing my name, voice, likeness or any other identifiable

representation of myself. These materials may appear in any form, style, color or medium whatsoever

now or hereafter known.

I certify that I am at least 18 years of age.

Signature ____________________________

Date_________________________________

Thank you for supporting Ronald McDonald House Charities

and the children and families that we serve.

House Volunteer Application Form Page 2

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