Weber-Morgan Health Weber-Morgan Health
By accepting this agreement I have electronically signed this statement. Please be aware that an electronic signature is as legally binding as a handwritten signature.
Current WMMRC Volunteers, please check that you have completed the following:
Signature: Initials: Completely read, understand and sign the "WMMRC Policy" (Sign this by checking the check box and filling in your initials.)

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By accepting this agreement I have electronically signed this statement. Please be aware that a electronic signature is a legally binding as a handwritten signature.

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Signature: Initials: Completely read, understand and sign the "WMMRC Media Release Policy" (Sign this by checking the check box and filling in your initials.)
Signature: Initials: Completely read, understand and sign the "WMMRC Volunteer Risk Policy" (Sign this by checking the check box and filling in your initials.)
Signature: Initials: Completely read, understand and sign the "Volunteer Confidentiality Policy" (Sign this by checking the check box and filling in your initials.)
Signature: Initials: Completely read, understand and sign the "Release of Confidential Policy" (Sign this by checking the check box and filling in your initials.)
Training
ICS = Incident Command System
Disaster Training
Other Related Training

I have the following: (check all that apply)

ICS - Intro to ICS
ICS 200 - ICS Intital Actions
ICS 700 - Nat. Incident Management
ICS 800 - Nat. Response Plan

I have the following: (check all that apply)

CPR Training
CDLS (Core Disaster Life Support)
BDLS (Basic Disaster Life Support)
Other:

 
I have read the above mentioned policies. Furthermore, I understand that I may call the WMMRC coordinator at 801-399-7100 and have any questions answered prior to signing them. Also, by signing, I agree that I will do my best to meet the training and participation criteria to maintain membership in the Weber-Morgan Medical Reserve Corps.
* Name of Volunteer: Date: Apr. 24, 2014

* Signatuare of Volunteer: Initials: (Sign this by checking the check box and filling in your initials.)