Join Our Volunteer Organization

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Name

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Email

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Birthdate

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Primary Address

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Primary Phone

We use text messaging for many of our announcements and coordination.

How did you hear about us?

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Choose your role/skill level

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Licensure/Certification Type

License/Cert Number

If Other/Student Role, Explain Below

ie: LCSW, student in PA program at WSU etc
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As a part of my volunteer orientation, the volunteer manual, blood borne pathogen training, aggressive patient/deescalation training, HIPAA training, and waiver of liability must be reviewed. Please see these documents in the resource section of your hub.

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Volunteer Release and Waiver of Liability

Do you understand that the services you provide to Nurses Global Outreach, Inc. may include activities that may be hazardous to you including, but not limited to exposure to infectious agents, unpredictable weather conditions, dangerous terrain, intoxicated or impaired patients, untreated psychiatric disorders, and other activities involving inherently dangerous activities?
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Do you understand that the scope of your relationship with Nurses Global Outreach, Inc. is limited to a volunteer position and that no compensation is expected in return for services provided by you; that Nurses Global Outreach, Inc. will not provide any benefits traditionally associated with employment to you; and that you are responsible for your own insurance coverage in the event of personal injury or illness as a result of your services to Nurses Global Outreach, Inc.?
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Do you grant and convey to Nurses Global, Inc. all right, title, and interests in any and all photographs, images, video, or audio recordings of you or your likeness or voice made by Nurses Global, Inc in connection with providing volunteer services to Nurses Global, Inc.?
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I, the Volunteer, release and forever discharge and hold harmless Nurses Global Outreach, Inc. and its successors and assigns from any and all liability, claims, and demands of whatever kind of nature, either in law or in equity, which arise or may hereafter arise from the services I provide to Nurses Global Outreach, Inc. I understand and acknowledge that this Release discharges Nurses Global Outreach, Inc. from any liability or claim that I may have against Nurses Global Outreach, Inc. with respect to bodily injury, personal injury, illness, death, or property damage that may result from the services I provide to Nurses Global Outreach, Inc. or occurring while I am providing volunteer services.
About Nurses Global Outreach, Inc./ICT Street Team
The ICT Street Team strives to remove the multiple barriers that often cause the homeless citizens of Wichita to miss opportunities to meet their own healthcare needs. We strive to bridge gaps of care to keep our homeless neighbors safe and healthy.
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Nurses Global Outreach, Inc./ICT Street Team
402 N. Topeka St
Wichita
KS
United States
Nurses Global Outreach, Inc./ICT Street Team logoNurses Global Outreach, Inc./ICT Street Team