Vocations Soccer Cup Volunteers Form

VOLUNTEER INFORMATION

Name*

First Last

Your Title*

Email Addrewss*

Cell Phone #*

Date of Birth*

Address*

Street Address City ZIP Code

Your Parish/School*

Choose Volunteer Type*

What would you prefer to help with?

SAFE ENVIRONMENT

Safe Environment Fingerprinting and Training Check List

Finger Printing Checked (Adults Only)
I Need to do Finger Printing (Adults Only)
Safe Environment Training completed (Adult/Youth)
I need to complete Safe Environment Training (Adult/Youth)

If you have not completed training, please read training info below
Completion of the training and Finger Printing will be verified by July 19 to participate.

Adult Volunteers need to complete or renew (renewal every 3 years) the Adult Safe Environment Training on the website of VIRTUS Online Training and take the course titled Protecting God's Children® Maltreatment 3.2 & Vulnerable Adults Combined_San Jose. Course must be completed by July 19.
Youth Volunteers need to complete or renew (renewal every 3 years) the Safe Environment Training on the website of VIRTUS Online Training and take the course titled Healthy Relationships For Teens 2.0. Course must be completed by July 19.
For VIRTUS Registration Instructions CLICK HERE. For the VIRTUS website to complete the course visit: https://www.virtusonline.org/virtus/

PARENTAL CONSENT

Parent/Guardian Name

First Last

Parent/Guardian relationship to the minor volunteer

Parent Consent

I the parent/guardian give consent and release for my child to volunteer at this event.

Parent/Guardian Cell Phone

Parent/Guardian Email

As a parent/guardian, type your name below as your electronic signature for your consent for your minor to volunteer.

PHOTO/VIDEO RELEASE

Photo/Video Release Consent*

I give consent to the Photo/Video Release. I grant the Diocese of San Jose, its directors, officers, employees, agents, and designees (collectively “DSJ”) non-revocable permission to capture my/my child's image and likeness in photographs, videotapes, motion pictures, recordings, or any other media (collectively “Images”). I acknowledge that DSJ will own such Images and further grant the DSJ permission to copyright, display, publish, distribute, use, modify, print and reprint such Images in any manner whatsoever related to DSJ business, including without limitation, publications, advertisements, brochures, web site images, or other electronic displays and transmissions thereof. I further waive any right to inspect or approve the use of the Image by the DSJ prior to its use. I forever release and hold the DSJ harmless from any and all liability arising out of the use of the Images in any manner or media whatsoever, and waive any and all claims and causes of action relating to use of the Images, including without limitation, claims for invasion of privacy rights or publicity. No compensation to be given.

PARTICIPATION ACTVITIY WAIVER

Activity General Liability Waiver*

I have read and consent to the waiver as written below for the Vocations Soccer Cup Games event

TO THE EXTENT PERMITTED BY LAW, I HOLD THE PARISH/SCHOOL AND DIOCESE OF SAN JOSE HARMLESS FROM ANY CLAIM OF INJURY, SICKNESS, ILLNESS OR DAMAGE THAT I /MY CHILD MAY SUFFER OR SUSTAIN DURING THE ACTIVITY LISTED ABOVE, WITH EXCEPTION TO INJURY OF DAMAGES ARISING OUT OF THE SOLE NEGLIGENCE OF THE PARISH/SCHOOL OR DIOCESE OF SAN JOSE. I ATTEST THAT I AM/MY CHILD IS PHYSICALLY FIT TO PARTICIPATE IN THIS EVENT.

IN THE EVENT THAT I/MY CHILD BECOME(S) ILL OR INJURED, I DO HEREBY CONSENT TO WHATEVER MEDICAL TREATMENT(S), INCLUDING BUT NOT LIMITED TO X-RAY, EXAMINATION, OR HOSPITAL CARE, CONSIDERED NECESSARY IN THE BEST JUDGEMENT OF THE ATTENDING PHYSICIAN AND PERFORMED BY OR UNDER THE SUPERVISION OF A MEMBER OF THE MEDICAL STAFF OF THE HOSPITAL AND/OR OTHER MEDICAL FACILITY PROVIDING THE TREATMENT. I AM NOT AWARE OF ANY MEDICAL CONDITION WHICH WOULD RENDER IT INAPPROPRIATE FOR ME/MY CHILD TO PARTICIPATE IN ANY ACTIVITY ASSOCIATED WITH THIS EVENT.

I/my child hereby release and agree to hold PARISH/SCHOOL AND DIOCESE OF SAN JOSE harmless from, and waive on behalf of myself/my child, my heirs, and any personal representatives, any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself/my child and/or property that may be caused by any act, or failure to act of the PARISH/SCHOOL AND DIOCESE OF SAN JOSE, or that may otherwise arise in any way in connection with any Participant services I/my child provide(s) to the PARISH/SCHOOL AND DIOCESE OF SAN JOSE.

I/my child understand that this release discharges the PARISH/SCHOOL AND DIOCESE OF SAN JOSE from any liability or claim that I/my child, my heirs, or any personal representatives may have against the parish with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise from, or in connection to, any Participant services provided to the PARISH/SCHOOL AND DIOCESE OF SAN JOSE.

This liability waiver and release extends to the PARISH/SCHOOL AND DIOCESE OF SAN JOSE together with its clergy, staff, and other Participants.

MEDICAL INFORMATION

Medical Plan Name*

Medical Plan Address

Street Address City State / Province / Region ZIP / Postal Code

Medical Plan Policy Number*

Medical Plan Phone Number*

EMERGENCY CONTACT INFORMATION

Emergency Contact(1) Name*

First Last

Emergency Contact(1) Phone*

Emergency Contact(2) Name*

First Last

Emergency Contact(2) Phone*

Type your name below as your electronic signature for your consent and participation activity waiver and photo/video release.*

Date of consent and waiver to the Vocations Soccer Cup Games Event .*