Once you have completed the General Application, please browse our Volunteer Opportunities list and feel free to sign up for any shifts that interest you. We will keep you updated as new opportunities arise.


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Your information


Required fields are marked with an asterisk (*).
Is this your first time volunteering at Peacemakers? *
Volunteer Type: *
Name of Group:
First name: *
Middle initial:
Last name: *
Birthday *

A valid date as MM/DD/YYYY (for example: 11/30/2015)
Street Address: *
City: *
State: *
Postal/zip: *
Primary Phone Number *
Secondary Phone Number:
Emergency Contact Name *
Emergency Contact Number *
Emergency Contact Relationship *
What special skills or areas of interest do you have? *
Through which ministry at Peacemakers are you interested in serving? *













Legal/Lifestyle Questions
The following questions are designed to protect the safety of our volunteers and those we serve. Any specific response will not necessarily preclude volunteers from participating at Peacemakers, as we have several modes through which people may serve. Please provide accurate information so we can determine the best way to proceed with your application.
Driver's License number and state:
Social Security Number:
Have you ever been under psychiatric care? If yes, please explain *
Have you at any time ever been arrested or charged? If yes, please explain *
Are you aware of having any traits or tendencies that could pose any threat to children, youth, or others? If yes, please explain *
Has your name ever been placed on any state's Responsible Individual List? If yes, please explain *

Waiver

PEACEMAKERS OF ROCKY MOUNT REQUIRED VOLUNTEER WAIVER AGREEMENT
I. WAIVER AND RELEASE FORM RELEASE OF LIABILITY
In return for being allowed to participate in Peacemakers of Rocky Mount volunteer activities and all related activities, including any activities incidental to such participation (“Volunteer Activities”), the undersigned Volunteer or Parent/Legal Guardian of Volunteer if Volunteer is under age 18 (hereafter referred to using “I”, “me”, or “my”) releases and agrees not to sue Peacemakers of Rocky Mount or its officers, directors, employees, sub-contractors, sponsors, agents and affiliates (“the Organization”) from all present and future claims that may be made by me, my family, estate, heirs, or assigns for property damage, personal injury, or wrongful death arising as a result of my participation in the Volunteer Activities wherever, whenever, or however the same may occur.

I understand and agree that the Organization is not responsible for any injury or property damage arising out of the Volunteer Activities, even if caused by their ordinary negligence or otherwise.

I understand that participation in the Volunteer Activities involves certain risks, including, but not limited to, serious injury and death. I am voluntarily participating in the Volunteer Activities with knowledge of the danger involved and I agree to accept all risks of participation.

I also agree to indemnify and hold harmless the Organization for all claims arising out of my participation in the Volunteer Activities.

I understand that this document is intended to be as broad and inclusive as permitted by the laws of the state in which the Volunteer Activities take place and agree that if any portion of this Agreement is invalid, the remainder will continue in full legal force and effect. I also acknowledge that the Organization has not arranged and do not carry any insurance of any kind for my benefit or that of Volunteer (if Volunteer is under 18), my parents, guardians, trustees, heirs, executors, administrators, successors and assigns. I represent that, to my knowledge, I am in good health and suffer no physical impairment that would or should prevent my participation in Volunteer Activities.

I also understand that this document is a contract which grants certain rights to and eliminates the liability of the Organization.
II. AUTHORIZATION FOR BACKGROUND REPORT
In connection with volunteering at PEACEMAKERS, I authorize PEACEMAKERS and or its agent, Protect My Ministry, to obtain a background report on me which may include information on my character, general reputation, personal characteristics, and mode of living from public record sources or personal interviews with previous employers or associates. I have the right, upon written request, to receive a written description of the nature and scope of the investigation requested and a written summary of my rights under the Fair Credit Reporting Act. I further release PEACEMAKERS, its affiliated companies, their officers, employees and agents, and specifically, Protect My Ministry, their affiliated companies, their officers, employees and agents from any liability and responsibility arising from the preparation of said report. I understand that false or misleading statements made on this authorization, or made during the volunteer process, will disqualify me from consideration as a volunteer or result in my immediate discharge if employed.
III. PUBLICITY RELEASE
In return for being allowed to participate in Peacemakers of Rocky Mount volunteer activities and all related activities, including any activities incidental to such participation (“Volunteer Activities”), the undersigned Volunteer or Parent/Legal Guardian of Volunteer if Volunteer is under age 18 (hereafter referred to using “I”, “me”, or “my”) hereby grants to the Organization, and each of its subsidiaries, affiliates, agents, advertising or promotional agencies, and partners, and all such entities’ officers, directors, agents, employees, respective successors and assigns (collectively, “Authorized Parties”), the absolute and irrevocable right and permission to use, publish, broadcast and/or copyright the use of Volunteer’s name, address, voice, photograph and/or likeness, caricature, and personal information, in its current form or as retouched, digitized, cropped, altered, distorted or modified in any way, in any and all advertising, promotional, or other materials based upon or derived from the Volunteer Activities in any manner, in any media whatsoever for any and all purposes, including by way of example but without limitation advertising, promoting or publicizing products and services throughout the universe, in perpetuity, in any and all media now known or hereafter devised (including without limitation on the Internet), without additional compensation. I further agree that anything derived there from will be owned solely by the Authorized Parties. I shall not authorize the use of any print, negative or other copy thereof by anyone other than the Authorized Parties. I understand that this document is intended to be as broad and inclusive as permitted by the laws of the state in which the Volunteer Activities take place and agree that if any portion of this Agreement is invalid, the remainder will continue in full legal force and effect