SOP_NUMBER: 109.01-att-5
TITLE: Visiting Volunteer Waiver of Liability
REFERENCE_CODE: VF01-0001
DIVISION: Inmate Services
TOPIC_AREA: Volunteer Services
EFFECTIVE_DATE: 2020-06-30
WORD_COUNT: 222
POWERDMS_URL: https://public.powerdms.com/GADOC/documents/233224
URL: https://gps.press/sop-data/109.01-att-5/

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

ATTACHMENTS:
  1. Volunteer Service Agreement
     URL: https://gps.press/sop-data/109.01-att-1/
  2. GDC Volunteer Application - Personal Data Sheet
     URL: https://gps.press/sop-data/109.01-att-2/
  3. Sample Request For Identification Card
     URL: https://gps.press/sop-data/109.01-att-3/
  4. Volunteer Services GCIC_NCIC Consent Form
     URL: https://gps.press/sop-data/109.01-att-4/
  5. Visiting Volunteer Waiver of Liability
     URL: https://gps.press/sop-data/109.01-att-5/
  6. Annual Volunteer Services Evaluation
     URL: https://gps.press/sop-data/109.01-att-6/
  7. Volunteer Application Processing Checklist
     URL: https://gps.press/sop-data/109.01-att-7/
  8. Volunteer ID Renewal Certification Validation Form
     URL: https://gps.press/sop-data/109.01-att-8/
  9. GDC OPS Background Screening Packet
     URL: https://gps.press/sop-data/109.01-att-9/

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FULL TEXT:
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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.