Would you like to help those isolated due to Covid-19?

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Completing the form, below, indicates that you have read and agree with the below statement;
1. I know of no reason, medical or otherwise, that would prevent me from performing the tasks required to participate in this volunteer activity.
2. I assume all risks of participating in the volunteer activity and full responsibility for my conduct and actions, including any injury to myself or others or damage to property that may result while volunteering, and I understand that Community Action Wirral is not responsibility for conditions that I create myself or those created by other volunteers or participants.
3. By completing this document, I affirm that the facts set forth in it are true and complete.
4. I understand that if I am accepted as a Volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal.
5. I agree to provide a copy of my driving license if required.
6. As part of the Community Action Wirral, it is essential that all Community Action Wirral volunteers maintain the strictest confidentiality.
7. All information which you have access to during your time with us must not be disclosed to any persons outside of Community Action Wirral.
8. Any breach of confidentiality will be deemed a disciplinary offence and appropriate action will be taken by Community Action Wirral.
9. I hereby state I have read and understood this agreement and will abide by the details contained herein and also understand that this agreement shall be duly binding for any and all involvement in Community Action Wirral.

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* 1. Contact Information

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* 2. Date of Birth

Date

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* 3. How would you like to help?

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* 5. If you answered yes above, please give details of the organisation.

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* 6. Do you have a DBS check?

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* 7. If yes, which organisation have you done your DBS check through?

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* 9. Emergency contact (please include name and contact number)

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