Request edit access
DVHS PTSA Adult Participant and Volunteer Waiver 2018-2019
ADULT PARTICIPANT / VOLUNTEER WAIVER, RELEASE, AND INDEMNITY AGREEMENT
PARTICIPANT WAIVER: I voluntarily agree to participate in PTA/PTSA Unit sponsored events and activities held during the school year. I recognize that the PTA/PTSA Unit has not undertaken any duty or responsibility for my safety and I agree to assume the full responsibility for all risk of bodily injury, death, disability, and property damage as a result of participating in the PTA/PTSA Unit sponsored events and activities. I recognize that these risks will vary based on the event and activity, and understand it is my responsibility to be aware of the risks before participating. I attest and verify that I am mentally and physically fit and able to participate in PTA/PTSA Unit sponsored events and activities. By my signature below, I hereby state that I understand there are risks involved in participating in PTA/PTSA Unit sponsored events and activities and willingly and voluntarily accept these risks. By my signature, I hereby surrender any right to seek reimbursement from the California State PTA, including all unit, council, and district PTAs, and all of their officers, directors, members and volunteers for injury sustained and liability incurred during my participation in PTA/PTSA Unit sponsored events and activities.
VOLUNTEER WAIVER: This section sets forth the responsibilities and understandings of the volunteer and of the PTA/PTSA Unit regarding volunteer’s participation in volunteer programs partially or wholly coordinated by the PTA/PTSA Unit during the school year. The volunteer and the PTA/PTSA Unit agree as follows:
1. The volunteer performs the service of the volunteer’s own free will, without promise, expectation, or receipt of remuneration. The volunteer is not an employee or agent of the PTA/PTSA Unit for any purpose and the volunteer’s services are not controlled nor mandated by the PTA/PTSA Unit.
2. If the volunteer is under the age of 18, the volunteer may only participate in volunteer service with the express written consent of the volunteer’s parent or guardian.
3. The volunteer understands and agrees that it is possible that the volunteer may be injured or otherwise harmed during volunteer service due to accidents, acts of nature, the volunteer’s negligent or intentional acts, or the negligent or intentional acts of others; that while the PTA/PTSA Unit has taken some steps to reduce the chances of injuries or harm to the volunteer, that the PTA/PTSA Unit has no control over most risks, and, thus, cannot and does not guarantee nor take any responsibility for the safety of the volunteer or the volunteer’s property while the volunteer is engaged in volunteer service; and that the volunteer must take full responsibility for himself or herself and assume the risk of harm or damage while serving by taking all necessary and reasonable precautions and acting in a manner that will help protect himself or herself and his or her property.
4. The volunteer agrees to waive and release the California State PTA, including all unit, council, and district PTAs, and all of their officers, directors, members, and volunteers from any and all potential claims for injury, illness, damage, or death which the volunteer may have against the PTA/PTSA Unit that might arise out of the volunteer’s service and to hold the PTA/PTSA Unit harmless there from.
5. The volunteer agrees and understands that injuries or losses to others, such as co-workers or the person(s) being helped, may occur as a result of the volunteer’s negligent or intentional acts during volunteer service, and that to avoid such harm, the volunteer must exercise care and act responsibly in serving others.
6. If any injury or loss to another does occur due to the volunteer’s intentional actions or due to volunteer’s negligent actions arising outside of the scope of the volunteer’s activities, the volunteer must accept the liability for and repair, or make reparations for, the harm done.
7. In projects where the volunteer will be transporting others in a non-PTA Unit owned vehicle, the volunteer will be required to provide proof of automobile insurance in order to participate.
8. Since volunteers are not the PTA/PTSA Unit employees, the PTA/PTSA Unit does not provide workers’ compensation coverage for injuries or illnesses to the volunteer arising out of volunteer activities.
I understand that the materials and tools provided by the PTA/PTSA Unit are and remain the property of the PTA/PTSA Unit, and I agree to return these tools and any remaining materials to the PTA/PTSA Unit at the end of my volunteer service. By signing below, I confirm that I have carefully read this document and fully understand its contents. I am aware that this is a release of liability and signed it of my own free will.
FIRST NAME (Signature):
LAST NAME (Signature):
Mobile Phone Number:
Including area code (XXX-XXX-XXXX)
Address / City / Zip Code:
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service