4.2 OLD FORM DO NOT USE VISIT WEBSITE FOR CURRENT FORM

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Challenge Alaska is a non-profit community-based agency whose mission is “improving the lives of people with disabilities and the whole community through therapeutic recreation, adaptive sports and education.” Our programs and services encourage healthy lifestyles;promote independence and empowerment, and leisure education.Your commitment as a volunteer is an essential component in this process. Please complete the following in full and submit with one copy of government issued photo identification such as a driver’s license.

As a condition of volunteering, I give permission for Challenge Alaska to conduct a background check on me, which may include a review of sex offender registries, child abuse and criminal history records. I understand that, if appointed, my position is conditional upon Challenge Alaska receiving no inappropriate information on my background.I hereby release and agree to hold harmless from liability Challenge Alaska, the officers, employees, and volunteers thereof, or any persons of the organization that may provide such information. I also understand that, regardless of previous appointments, Challenge Alaska is not obligated to appoint me to a volunteer position.The relationship between Challenge Alaska and volunteers is an “At Will” arrangement and may be terminated at any time by the volunteer or Challenge Alaska. All information provided to Challenge Alaska through the course of your volunteer experience will remain confidential. Challenge Alaska will not discriminate against any person on the basis of race, creed, color, national origin, marital status, gender, sexual orientation, or disability.

I have been offered a copy of the Volunteer Confidentiality Agreement and agree to abide by the practices outlined therein.

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Who will be participating?

Adult  Someone Under 18 or Legally Incapacitated

Signee Information

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Self, family, friends, school, work, etc.
















Please include name, contact information, capacity in which you know them and how long you've known them.

By clicking 'I Agree' below, you agree that you have read and agree with the terms of the waiver and that the information you provided is accurate. You furthermore agree that your submission of this form, via the 'I Agree' button, shall constitute the execution of this document in exactly the same manner as if you had signed, by hand, a paper version of this agreement.