1853 Capital Boulevard | Raleigh, NC 27604 

To be filled out by the Parent/Guardian for minors under 18 years old 

If you are signing a waiver for your minor child, please enter your information below.  You must be the child’s parent or legal guardian in order to sign the liability waiver.  The volunteer must bring a signed copy of this form on the first day he/she volunteers.   The Green Chair Project, Inc. will keep this form on file for any shifts the minor may work in the future.


Parent/Guardian Name:  ________________________________________________________________

Minor’s Birth Date:  ________________________________________________________________

Parent/Guardian’s Email Address:  ________________________________________________________________

Parent/Guardian’s Phone Number:  ________________________________________________________________

Parent/Guardian Alternate Phone Number:  ________________________________________________________________


Minor Release (For use if any volunteer is under the age of 18) 

I, THE MINOR'S PARENT and/or legal guardian, understand the nature of the Project (as defined above) and the minor's experience and capabilities and believe the minor to be qualified and able to serve as a volunteer with the Project. I hereby release, discharge, covenant not to sue, and agree to indemnify and save and hold harmless each of the Releasees (as defined above) from all liability, claims, demands, losses, or damages on the minor's account caused or alleged to be caused in whole or in part by the negligence of the Releasees or otherwise, and further agree that if, despite this release, I, the minor, or anyone on the minor's behalf makes a claim against any of the Releasees named above, I will indemnify, save, and hold harmless each of the Releasees from any litigation expenses, attorney fees, loss liability, damage, or cost any may incur as the result of any such claim.


Minor’s name:  _________________________________________________________________

Minor’s address:  _________________________________________________________________

Parent/Guardian address if different from minor’s address:


Parent/Guardian Signature:  _________________________________________________________________


Date:  ____________________________