Please download and complete the following documents.  These documents can be faxed to FAX HERE or mailed to:

City of Lincoln—Aging Partners 

555 S. 9th Street

Lincoln, NE 68508

Please DO NOT UPLOAD the Background Check document HERE. The Waiver and Code of Conduct can be uploaded.

Summary
The City of Lincoln seeks willing volunteers who want to connect with and provide assistance to their neighbors through this uniquely challenging time. Volunteers will be paired with neighbors in need who may be homebound and need assistance with daily tasks, or who may simply want to talk to a friendly person. Physical tasks may include but are not limited to no contact “store to door” grocery and medication delivery and other basic errands. In the spirit of combating social and emotional isolation, pairs are encouraged to communicate with each other regularly via phone, FaceTime, or other remote means.

Location
Will vary by connection

Primary Activities

• Connect with a neighbor on an ongoing basis through remote means such as telephone, FaceTime, etc.
• Conduct physical errands or tasks to assist assigned neighbors
• Submit monthly activity reports indicating what support has been given and how many hours were spent volunteering
• Perform all physical tasks with the utmost attention to COVID-19 precautions

Expectations

• A high level of professionalism is expected in every interaction
  Volunteers will not enter the home of a paired neighbor
• Volunteers will not provide transportation to the paired neighbor
• High attention to COVID-19 protection strategies
• Initial training through the City of Lincoln is required
• Background checks will be conducted on potential volunteers to protect the safety of all involved
• Volunteers will notify the City of Lincoln if they are unable to help the neighbor so another match can be found

Safety

• Wash hands regularly with soap and water for 20 seconds, disinfect surfaces regularly, avoid direct contact with others whenever possible, avoid shaking hands, touching your face, and practice good hygiene.
• Practice safe social distancing by keeping 6 feet distance from others.
• If you are feeling unwell, have a fever of 100.4 degrees F, have flu-like symptoms or respiratory discomfort stay home and let the City of Lincoln know. Consult with a doctor or health care professional.
• In times of distress, the work of a healthy volunteer is vital, but personal health and safety are always of primary importance.

Please provide two references (not relatives) who are able to supply information about you.

Please read and sign: I have read the above application and certify to the truth of the above statements. If I am chosen for the position of Volunteer in the volunteer program, I hereby take on the responsibility of adhering to any rules required. I will abide by my schedule and understand that any unauthorized absences will result in my being replaced. I further understand that any false or misleading statements will be cause for rejection of this application or for dismissal after appointment. I authorize and request any reference to answer any and all questions that may be asked, and I hold such persons harmless for giving all information within their knowledge or record. I authorize all background checks and other investigation to determine my suitability as a Volunteer.

WARNING OF RISK, WAIVER, AND RELEASE OF ALL CLAIMS (VOLUNTEER)

Volunteer Obligations. Volunteer is required to follow instructions and any safety guidelines closely. The likelihood of injury may be reduced by Volunteer adhering to safety rules or procedures. Volunteer agrees to conduct the volunteer activity in a safe and professional manner at all times. Volunteer agrees not to enter the residence of the recipient of the volunteer activity except under emergency circumstances.

Assumption of Risk and Release of Claims. Volunteer is fully aware and understands the specific risks associated with this volunteer activity, including physical injury, sickness (including COVID-19), and death, and that this volunteer activity may be hazardous to the Volunteer. Volunteer agrees to assume and accept the full risks associated with this volunteer activity without limitation, or in the alternative waives all rights to notice of risks associated with this volunteer activity and any activities connected or associated with this volunteer activity, including any loss or damage to clothing and/or personal equipment; any mental and/or physical injuries, including illness, permanent and/or partial disability; severe social and/or economic loss; attorney’s fees; and/or any other damages or loss which may result not only from actions, inactions or negligence, of Volunteer, or of others, or in the condition of the premises or of any equipment used. Volunteer agrees to waive and relinquish all claims Volunteer may have as a result of or related to the volunteer activity against the City of Lincoln and their officials, officers, agents, volunteers, and employees.  Volunteer further assumes all the foregoing risks and accepts personal responsibility for all costs associated with the risks or injuries that Volunteer incurs or causes.

Indemnification. To the fullest extent permitted by law, Volunteer shall indemnify, covenant not to sue, defend, release, and hold forever harmless City of Lincoln or their officers, agents, volunteers, and employees, as well as the recipient of the volunteer activity, from and against claims, damages, losses, and expenses, including but not limited to attorney’s fees, arising out of or resulting from this volunteer activity, that results in any claim for damage whatsoever, including without limitation, any bodily injury, sickness, disease, death, or any injury to or destruction of tangible or intangible property, including any loss of use resulting therefrom that is caused in whole or in part by the intentional or negligent act or omission associated therewith.

No City Employment and Insurance Coverage. Volunteer expressly understands that this volunteer activity does not constitute City employment. Volunteer agrees there is no entitlement to any City benefits including, but not limited to, overtime, retirement benefits, workers’ compensation, sick leave, or injury leave. Volunteer understands City undertakes no liability or financial obligation on behalf of Volunteer as a result of the volunteer activity. Volunteer’s health, homeowners, umbrella, and auto insurance (if any) shall provide primary coverage in the event of any injuries or losses to Volunteer, the recipient of the volunteer activity, or others arising out of the volunteer activity.

Effect of Waiver and Release. This Waiver and Release shall be construed and enforced in accordance with the laws of the State of Nebraska; contains the entire understanding of the parties superseding any prior negotiations; shall be read as broadly and inclusively as permitted by law; and in the event any provision is rendered invalid, the remainder shall still remain valid and enforceable to the fullest extent of the law.

Acknowledgment and Capacity. Volunteer hereby acknowledges and represents unqualified authority to execute the same on their own behalf and/or on behalf of the Volunteer. Volunteer has read, fully understood, and freely agrees to this Warning of Risk, Waiver, and Release of All Claims.

NOTE: This waiver will also need to be signed in person and stored in your volunteer file.