Volunteer Employee Consent Form When Operating County Equipment
Policy #53
VOLUNTEER EMPLOYEE CONSENT FORM WHEN OPERATING COUNTY EQUIPMENT
Date Adopted: July 23, 2018 Minute Book: 41 Page 54
POLICY
To implement a procedure outlining guidelines for non‑county employees operating county equipment.
PROCEDURE
At the advisement of the County’s liability insurance provider and for the benefit of non‑county employees operating County equipment or driving County vehicles, the attached policy (see page 2) has been established.
This policy requires all volunteers to complete and sign the attached form before operating County vehicles or using County equipment.
It is the responsibility of the County department head supervising the volunteer to:
-
Ensure the form is completed before the volunteer operates any County vehicle or equipment
-
Forward the signed documents to the Personnel Director in a timely manner
If the volunteer will not be driving or operating County‑owned equipment, the form does not need to be signed.
Houston County Volunteer Application
Name: Date of Birth: ___ / ___ / ___ Address: Phone: ( ___ ) ___ – ____ Email:
Emergency Contact Name: Emergency Contact Phone Number: ( ___ ) ___ – ____
As a volunteer for Houston County, Alabama (“County”), it is possible that you will:
-
Operate a vehicle or heavy equipment
-
Load or assist with heavy equipment
-
Use tools, including power and hand tools, capable of causing injury
Such activities create potential risks to both volunteers and the public. Therefore, the County permits volunteer participation only when individuals are free from the influence of alcohol, mind‑altering substances, or illegal drugs.
Volunteer Requirements
1. Alcohol & Drug Use
All volunteers must:
-
Refrain from alcohol use for at least four (4) hours prior to volunteering
-
Be in a physical and mental condition free from the influence of drugs or alcohol
2. Accident Reporting
All volunteers must immediately report any injury or damage occurring while volunteering or operating County equipment to the appropriate department head.
2.1 Post‑Accident Testing Consent
By signing this document, the volunteer agrees to submit to post‑accident drug/alcohol testing:
-
Drug test: within 32 hours of the accident
-
Blood alcohol test: within 8 hours of the accident
2.2 Who Must Be Tested
Any volunteer whose performance:
-
Contributed to the accident, or
-
Cannot be completely ruled out as a contributing factor
…shall be subject to testing.
2.3 Scheduling of Testing
The department head or designee shall schedule the drug screening immediately following any reportable incident involving:
-
Medical treatment
-
Property damage
-
Injury to a citizen
-
Vehicle‑related accident
2.4 Transport to Testing Site
The department head will arrange for the volunteer to be transported to a designated collection site as soon as practicable.
2.4.1 Medical Incapacity
If the volunteer is medically incapacitated or unable to consent, no testing will occur during the incapacity.
2.4.2 Emergency Medical Care
Nothing in this policy requires delaying necessary medical attention or prevents a volunteer from leaving the scene to obtain emergency care.
2.4.3 CDL Drivers
All CDL‑licensed volunteers will be tested in accordance with Federal Highway Administration (FHWA) requirements.
Volunteer Consent
By signing this application, I hereby consent to and agree to abide by the above‑stated requirements:
Signature: ____________________________ Date: ___ / ___ / ___