Volunteer Waiver

This agreement forms part of and must be attached to the Volunteer Application Form. Before you start volunteering, the Canadian Cancer Society requires your agreement on the following:

• I understand that the Society has a volunteer screening process in place, and that I may be asked to undergo an orientation, interview, reference checking, and /or criminal records and child abuse registry check, depending on the nature of the volunteer position for which I am applying.
  
• I will abstain from smoking or using tobacco while volunteering and I recognize that all Canadian Cancer Society events and services are smoke and tobacco free.
  
• I will abstain from any use of alcohol or drugs while volunteering for the Canadian Cancer Society.
  
• I grant permission to the Canadian Cancer Society to use my name, any photo or video images of me and any comments made by me in writing or otherwise, for promotional purposes in any form of media (i.e. TV, radio, web or print)
  
• I understand that confidentiality is fundamental to all programs of the Canadian Cancer Society and I will be sensitive to the need for confidentiality. By signing below, I am indicating that I will not use or disclose in any manner to any third party (other than to Canadian Cancer Society attorneys, auditors, or authorized government officials) any information without the prior express written consent of the Canadian Cancer Society.
  
• I understand that I cannot give medical advice (which includes comments and suggestions that personalize medical information and influence treatment decisions). If someone is seeking information, I will direct him or her to a Canadian Cancer Society employee or the toll-free Cancer Information Service at 1-888-939-3333.
  
• I understand that I am representing the Canadian Cancer Society during my time volunteering and I agree to act in a professional manner at all times. I acknowledge receipt of the Volunteer Code of Conduct (included with the application form) and agree to follow it all times while volunteering for the Society.
  
• I hereby release and discharge the Canadian Cancer Society, its agents, employees and licensees from any claim or action that I may have with respect to the use of any of the above or my participation in any related Canadian Cancer Society activities, while volunteering for the Canadian Cancer Society.
  

By signing below, I acknowledge that the information provided is true and accurate and that I have read, understood, and will abide by the Volunteer Agreement above. I grant the Canadian Cancer Society permission to contact the references listed on my application form and follow up on any information provided.

Print name: _____________________________

Signature: ______________________________

Witness signature: _______________________

Date: __________________________________

The Canadian Cancer Society respects your privacy. We protect your personal information and adhere to all legislative requirements with respect to privacy. We do not rent, sell or trade our mailing lists. We use your personal information to provide services and to keep you informed and up to date on activities of the Canadian Cancer Society, including programs, services, special events, funding needs, opportunities to volunteer or to give and more through periodic contact from the Canadian Cancer Society. If at any time you wish to be removed from any of these contacts please contact the CCS-NSD Privacy Officer, Carol Zachernuk, Director of Operations, by telephone 1-800-639-0222 or email ccs.ns@ns.cancer.ca