Volunteer Liability Waiver

VOLUNTEER INFORMATION:

Name: ____________________________________________________________________________

Address: __________________________________________________________________________

Phone Number & Email: __________________________________________________________

Emergency Contact Information:

Name: ____________________________________________________________________________

Relationship to volunteer: __________________Phone Number: ______________________

VOLUNTEER AGREEMENT

As a volunteer, I release and hold harmless Crossroads Community Food Network and their successors from any and all claims, costs, suits, actions, judgments, or expenses upon any damage, loss, or injury to me or to my property which may arise from volunteering.

I acknowledge that I am fully aware of any and all risks posed by volunteering and that I have no medical condition that prevents me from doing so.

I give permission to be photographed or filmed by Crossroads, community partners, or the media for promotional purposes distributed via print materials, the internet, or other media outlets.

In signing below, I acknowledge that I have read and understand this volunteer agreement.

If you are interested in SSL hours, please circle here:       yes       no

Signature: ________________________________________________________________________

IF UNDER 18, A PARENT OR LEGAL GUARDIAN MUST SIGN BELOW:

Parent/guardian signature:  _______________________________________________________

Anti-Discrimination Statement

Crossroads has a strict zero-tolerance nondiscrimination and anti-racism policy. We recognize that systemic racism is historical and persistent. Our food system was built under colonialism, institutionalized racism, and capitalism, and many negative aspects of it continue to disproportionately affect Black, Brown, Indigenous, People of Color (BIPOC), and other community members. We are working towards creating more inclusive spaces and calling out oppressive behavior, defined as any conduct that demeans, marginalizes, rejects, threatens, or harms anyone on the basis of ability, age, cultural background, education, ethnicity, gender, immigration status, language, nationality, physical appearance, race, religion, or sexual orientation.

If a volunteer conducts themselves in a way that demeans, marginalizes, rejects, threatens, or harms anyone on the basis of ability, age, cultural background, education, ethnicity, gender, immigration status, language, nationality, physical appearance, race, religion, or sexual orientation they will be asked to remove themselves from the situation and may be asked not to return to volunteer.

By signing below you acknowledge this statement and agree to adhere to these practices.  

Signature: ________________________________________________________________________