Priority Charter Schools

CCA Temple Georgetown Cedar Park

Parent Volunteer Organization Information Form

Welcome to Priority Charter Schools! We are excited that you are here and look forward to a great year! We hope that
not only will your student find their place here, but that you will as well. To encourage parental involvement and
support, TCA, CCA, GCA and CPCA are creating a Parent Volunteer Organization (PVO). In order to protect our
students we ask that all parents/guardians/family members seeking to volunteer, first complete the Criminal
History Consent Form. This information will be viewed only by PCS and campus administration staff and will be
held in strictest of confidence. To serve in one of the many opportunities in support of PCS students, please
complete and return this form. All completed parent/guardian/family member forms will be stored and protected
by the school. The Parent Volunteer Organizer will get in contact with parents/guardian/family members and the
PCS staff in an effort to fill all possible volunteer opportunities. We discourage volunteering in your child's
classroom since this will create a disturbance in your child's learning environment. Exceptions to this policy are
classroom parties and field trips, which do not require a completion of this form. Please take a moment and fill
out all the required information below and check list showing area of interest. Thank you!

PERSONAL INFORMATION

Date of Application _____/_____/_____ Social Security _______-______-________

PLEASE PRINT LEGIBLE
Name _______________________________________________ Drivers License________________ State______
Last First Middle

Address_____________________________________________________________________________________
Street City State Zip

Phone______________________________________________ Date of Birth _______-______-________

Email______________________________________

Please provide any other name used for prior employment than differs from above:

Last M.I. First

Last M.I. First

Last M.I. First

Only campus administration will have access to your background check results. A parent volunteer coordinator
will only use the contact information you provide in order to communicate with you and assist the staff of PCS
with volunteer opportunities.

(Please initial) I understand that my background check results will be handled with the strictest of
confidence. Only my contact information will be given to the volunteer coordinator/campus secretary in order
to communicate volunteer opportunities.

Release Statement
I understand that the information I am providing about age, sex and ethnicity will not be used to determine
eligibility for volunteering, but will be used only for the purpose of obtaining criminal history record information.

I hereby agree and acknowledge that Priority Charter Schools, in its sole discretion and for any reason whatsoever
may deny a volunteer offer to me upon receipt and review of my criminal record.

I give consent to Priority Charter Schools to perform criminal background checks as required by Texas Education
Agency, (Texas Education Code, Section 22.083)

Release of Liability and Indemnity Contract

In consideration of being allowed to act as a Volunteer at no cost to Priority Charter Schools, whereby my child
and/or other children may enhance their education, I do hereby release and forever discharge Priority Charter
Schools, its Board of Directors and all other volunteers, all employees and agents of Priority Charter Schools, and
all students of Priority Charter Schools from any and all claims, demands, actions, causes of action and suits at law
or equity arising out of or in any way connected with the Volunteer Program of Priority Charter Schools and my
presence in or on Priority Charter Schools property.

I further agree that I enter this Volunteer Program of my own free will, to serve without pay, understanding that I
am not an employee or agent of Priority Charter Schools and therefore I am not covered by any of its insurance
programs or policies and therefore I assume all responsibility for any injury, accident or illness that may occur
to me during my volunteer service and release Priority Charter Schools, its Board of Directors, agents, and
employees, from any and all liability from the same, and hereby agree to indemnify them and save them harmless
for any sums that they, or any of them, may be required to pay on my account.

I also agree that a recommendation from the building principal is required and that my acceptance as a volunteer
is subject to approval by the Superintendent and Board of Directors.

This release and indemnity is given voluntarily and knowingly with full understanding of its meaning and with my
full consent to be legally bound hereby:

Volunteer Name (print):

Volunteer's Signature:
Please check all the areas of interest/volunteer work that apply. (Not all activities may apply to all campuses)

Classroom supplies Teacher Appreciation week

Fall Festival Fund Raiser
Book Fair Community Outreach Programs
Workroom aid (copies etc.) Athletic Events
Office Aid Picture Day
Christmas/4th of July Parade Library
Cafeteria Clean-up Merit Sale

List any additional volunteer information below: (i.e. dates/times available if known)