VOLUNTEER INFORM MATION FO ORM
Name: __ ____________ ___________ ____________ ___________________________________________ Address, C City, State, Zip:_________ ____________ ___________________________________________ Phone: __ ______________________ ___________ ____________________________________________ Emergenccy Contact (naame/phone): __________ ____________________________________________ Email:___ ____________ ___________ ____________ ___________________________________________ I give e permission ffor my email aaddress to be e added to Thhe GardenWo orks Project newsletter listt. I understand that images of me e volunteering may appea r in GardenW Works Project communications. VOLUNTEER W V WAIVER, RELEEASE, HOLD H HARMLESS AN ND INDEMNIFFICATION AGR REEMENT I have agre eed to serve ass a volunteer fo or The GardenW Works Project,, and I recognize that my volunteer particip pation is a privilegge afforded to me by The GardenWorks Pro oject. I fully unnderstand, app preciate and asssume all risks associated with my volun nteer duties. In n exchange forr my participatiion, I hereby agree to the folllowing: a))
I voluntarilyy waive, releasse, and hold haarmless The GaardenWorks Prroject, Board of Directors, volunteers, clients, and client’s landlord ds, from any annd all claims, caauses of action n and damagess for ner connected with, directly o bodily injurry or death that I may suffer aas a result of, oor in any mann or indirectly, m my participatio on as a GardenW Works Project volunteer. I understand thatt this waiver and release precludes my righ ht to recovery o of damages in the event I am m injured in thee course of my duties. volunteer d b)) I shall defen nd, hold harmless and indem mnify The GardeenWorks Projeect, Board of D Directors, volun nteers, clients, and d client’s landlo ords, from and against all dam mages, claims, liabilities, causes of action, judgments, settlements, ccosts and expe enses (includingg, but not limitted to, reasonaable expert wittness ey fees) that m may at any time e arise or be claaimed by any person as a result of bodily injury, and attorne death or property damage e, or as a resullt of any other claim or causee of action of aany nature whatsoeverr, arising from or in any mann ner connectedd with, directly or indirectly, m my negligent o or intentional acts or omissio ons in perform ming my volunt eer duties.
I have read d, fully understtand and agree e to the assumption of risk, reelease, hold haarmless, and in ndemnification n terms set fforth above.
nt Signature__ ___________ ___________ ___________________________ Date________________ Participan Note: If participant is u under 18 yearrs of age, a paarent or legall guardian mu ust sign this aagreement on n behalf of the participant. Parent Siggnature (if applicable)____ ___________ _______________________________________________