Individual Volunteer Form

Do you need to complete hours for: Court, School, Church, etc.? You MUST enroll into our Community Service Program in the Administration Office. Do not submit a Volunteer Form if you need your hours verified & signed. Contact Secilia at 209.467.0703

  • FORMS ARE TO BE SUBMITTED BY ADULTS OR CHAPERONES ONLY. (IF YOU ARE UNDER THE AGE OF 18, PLEASE DO NOT SUBMIT A FORM)
  • Volunteerism

  • When are you available to volunteer? (Please mark all that apply)

  • In Case of Emergency Contact

  • -Long pants (no shorts or capris). -Sleeved shirt (T‐shirts are good. no tank‐tops). -Closed toed shoes (no sandals or high heels).
    -Aprons, hairnets and gloves will be provided. Please do not bring any personal belongings. We do not have a secure storage area and can not be responsible for lost/stolen items.
  • Out of respect and privacy for our clients, we do not permit any forms of video, photography, evangelization and/or interviews with our clients on our campus.
    COMMUNITY SERVICE PROGRAM If you need to track your hours for any reason (court, school, service clubs, etc.), you will need to register for our Community Service Program. Please call 209.467.0703 for details.
    PROCEDURES Follow all staff instructions, safety procedures, and tasks assigned. Inform staff immediately if you are not comfortable with an assigned task.
    YOUTH & CHAPERONE POLICY Volunteers under 18 years of age (youth) must have an adult chaperone. One adult may chaperone up to 5 youth. • Volunteers must be a minimum of 16 years of age to volunteer in the kitchen area. Youth under the age of 16 are welcome to volunteer in our dining room. • Chaperones MUST be actively supervising and volunteering alongside the minor(s) throughout the entire volunteer experience.

    Volunteers have the right to work in an environment free from harassment. Please inform a member of staff if any problems should arise.
  • My signature below acknowledges my understanding that I may be photographed or captured in video recordings during my volunteer experience. I hereby authorize St. Mary’s Dining Room to publish any photography/video taken of me for use in St. Mary’s Dining Room’s publications or other media material produced including, but not limited to: brochures, television, websites, social media and/or other marketing materials. It is understood that my participation in any publication, websites, or other media produced by St. Mary’s Dining Room, and/or an entity acting with their permission, confers upon me no rights of compensation or ownership whatsoever.
 

Verification