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Registration Form

Surname Given Name(s) Date of Birth Gender
Other Members of the Household, including children (please state D.O.B. of Children):
Surname Given Name(s) Date of Birth Gender
Your Contact Details:
Phone
Fax
Other
Email
Your Address Details:
Property Name
Nearest Town
Postal Address
Line 1
Line 2
Suburb/Town
State
Post Code

Directions to property from nearest main road:

Please Select

Quarters
In House
Seperate Cottage
Facilities for Van

Brief Outline of Accommodation:
or other facilities suitable to caravan/motorhome/camper or tent that may be available to the volunteer

Notes on Accommodation:
How will a volunteer benefit you at this time:
Agreement and Consent:

I/We,

understand that the volunteer:

  1. will hold a current approved criminal history check
  2. is to have reasonable time off
  3. will not be required to undertake tasks that he/she is uncomfortable performing or not skilled for
  4. will respect the confidentiality of information pertaining to this agreement

understand my/our responsibility to:

  1. provide appropriate access to a living environment that is in a safe and clean condition
  2. respect the confidentiality of information gained about the volunteer
  3. notify the volunteer of the location of any hazardous items that may be considered dangerous to the safety, security and well-being of the volunteer
  4. inform the volunteer about any safety and emergency procedures in place on the property
  5. abide by the current policies and procedures of Outback Links

Name: Dated:

 

 

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