Volunteer Registration

Thank you for your interest in volunteering with Chemainus Harvest House Food Bank Society, and for taking the time to fill in this
Volunteer Registration. All volunteers must provide a Criminal Record Check, agree to and sign the Volunteer Oath and sign acceptance
and understanding of the volunteer manual. These forms will be provided upon receiving this registration form.

It is understood all volunteers of Chemainus Harvest House Food Bank:

  • Abide by the code(s) of conduct and confidentiality
  • Support the initiatives of the Society
  • Arrange for a replacement if unable to work as scheduled
  • Take direction from the individual in charge of your shift
  • Must provide a Criminal Record Check (provided upon receipt of registration form)
  • Must sign the Volunteer Oath (provided upon receipt of registration form)
  • Read and sign the volunteer manual

Note: Recipients may volunteer with Harvest House Food Bank, but may not act in the positon of intake, registration, or in the distribution of food to other recipients. Recipients may not be members of the Chemainus Harvest House Society. However, all volunteers are encouraged to become members of Chemainus Harvest House Food Bank Society. These forms are provided at orientation.

Thanks for your interest in working alongside us to serve our community!

*Indicates a required field

Volunteer Last Name:*

Volunteer First Name:*

Volunteer Primary Phone:*

Volunteer Alternate Phone:

Volunteer Email:*

Confirm Email:*

Volunteer Address:*

Volunteer City/Town:*

Volunteer Postal Code:*

Emergency Contact Name:*

Emergency Contact Phone:*

Emergency Contact Email:*

Emergency Contact Relationship to You:*

Employer, if working (We ask as some Employers donate towards employee volunteer hours):

0

I would like to volunteer with Harvest House Food Bank:*


Medical History:
Volunteering sometimes requires lifting (heavy at times), shifts of 2 – 3 hours bagging, cutting, packaging, climbing a short flight of cement stairs, picking up donated items, and helping with food drives.

Do you have any physical limitations that would prevent you from lifting more than 20-30 lbs?*
NoYes

If yes, please identify any medical issues or physical limitations so we can best suggest volunteer duties.
Please be aware that Chemainus Harvest House Society Food Bank Society does not assume any liability for injury or medical condition incurred while volunteering with the Society.


Can we add your name to our On-Call list to fill last minute scheduling gaps?*
NoYes

Select your preferred choice of day(s), time(s) and location you would be able to volunteer:
Mondays ­- loading 8:30 am in Chemainus for delivery to Crofton and/or distributing 9:30 am to 10:30 am in CroftonThursdays - 9:30 am – 11:30. Duties include sorting, bagging, stocking shelves, cleaningFridays - 11:00 am – 1:00 pm. Duties include preparation, serving recipients, cleaning up

Willing to participate in other fund raising activities:
NoYes