I understand and accept that in joining the Auxiliary and becoming a volunteer at Northside Hospital Atlanta, I hereby agree to the following:

• Submitting to a criminal background check.

• Wearing my photo identification badge and official uniform at all times when working at my service.

• Volunteering a minimum of once a week, in the service I am assigned at the designated time.

• Providing a service commitment of 100 hours per year and a minimum of 1 year.

• Providing advanced notice to my service area when I am unable to serve my assigned time and day, except in an extreme emergency.

• Recognizing the Auxiliary is unable to guarantee volunteer placement in the selected area of interest.

• Joining the Auxiliary is not a path to employment nor does it provide an opportunity for job shadowing, internship or externship.

• Knowing the Auxiliary is expressly unable to commit to any required volunteer commitments.

The Auxiliary will attempt to make volunteer assignments based on the applicant’s interests and physical & mental abilities. We cannot guarantee that a volunteer assignment will be available that meets an applicant’s special needs or limitations.

In witness of my signature below, I certify that all information provided in this application is true and correct to the best of my knowledge. I understand that any falsification or significant omission of any information requested herein will be considered sufficient cause for discharge without prior warning at any time during my service with Northside Hospital Atlanta Auxiliary.

I hereby elect and agree to be covered by Northside Hospital’s Worker’s Compensation Program for any accident or injury sustained during the course of my volunteer service to Northside Hospital. I acknowledge that I am not considered an employee for any other purposes and am not entitled to any other benefits available to employees.