SOP 109.01-att-5: Visiting Volunteer Waiver of Liability

Division:
Inmate Services
Effective Date:
June 30, 2020
Reference Code:
VF01-0001
Topic Area:
Volunteer Services
PowerDMS:
View on PowerDMS
Length:
222 words

Summary

This is a waiver and liability release form that all visiting volunteers must sign before working with offenders in GDC facilities. The form collects volunteer contact information, confirms the volunteer understands the risks of working with offenders, and releases GDC from liability claims. It also authorizes background checks and requires disclosure of any criminal convictions or current parole/probation status.

Key Topics

  • volunteer waiver
  • liability release
  • volunteer background check
  • criminal history disclosure
  • parole probation status
  • volunteer form
  • inmate interaction
  • GDC facility volunteer
  • volunteer screening
  • risk acknowledgment

Full Text

SOP 109.01
Attachment 5
6/30/20

COMMUNITY RESOURCES FOR CORRECTIONS

Visiting Volunteer Waiver of Liability

Name________________________________________________ SS# ______________________

Address (Street)________________________________________________________________________

(City, State, Zip) ______________________________________________________________________

Telephone (Home)_____________________ (Work) _____________________

Name of Group and Activity in GDC Facility________________________________________________

Date_________________ Time In _______________

In consideration of having been accepted as a volunteer for the above listed activity, and with the
knowledge that I will be working, directly and indirectly, with offenders, I recognize fully that my
presence may involve some element of risk.

I, the undersigned, do hereby waive and release any and all rights or claims of any kind or nature which
may exist or accrue in the future against Georgia Department of Corrections, (Name of Facility), its
personnel, employees, staff or agents because of, as a result of, or in connection with the duties,
responsibilities and work which I will undertake.

In making this application, I hereby give the Georgia Department of Corrections authority to make
inquires with police records as may be deemed necessary to ascertain my suitability as a volunteer.

________________________________________ _____________
Signature of Volunteer Date

Have you ever been convicted of a criminal offense? ______Yes _________ No If yes, explain
briefly: _____________________________________________________________________________

Are you currently on parole or probation? _______Yes _________No If yes, explain briefly?
____________________________________________________________________________________

Retention Schedule: Upon completion, this form shall become part of the volunteer’s file to be maintained for two
(2) years past termination of the volunteer’s services.

Attachments (9)

  1. Volunteer Service Agreement (1,352 words)
  2. GDC Volunteer Application - Personal Data Sheet (336 words)
  3. Sample Request For Identification Card (272 words)
  4. Volunteer Services GCIC_NCIC Consent Form (132 words)
  5. Visiting Volunteer Waiver of Liability (222 words)
  6. Annual Volunteer Services Evaluation (186 words)
  7. Volunteer Application Processing Checklist (89 words)
  8. Volunteer ID Renewal Certification Validation Form (152 words)
  9. GDC OPS Background Screening Packet (1,936 words)
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