Friday, September 1, 2017

CCFSC Office Courtyard
11155 Mountain View Ave, Loma Linda, CA 92354

5:30pm - 7:30pm
Volunteers must be at least 14 years old to participate.

First Name:
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Last Name:
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Group / School / Organization:
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Are you 14 years old or older?
Must be at least 14 years old to participate as a volunteer for the event.
Are you available 5:30pm - 7:30 pm?
Have you previously volunteered with CCFSC?
I, “Participant," acknowledge that I have voluntarily applied to participate in the Candle Lighting Ceremony ("Event”) hosted by Childhood Cancer Foundation of Southern California, Inc. (“CCFSC”) at the Mountain View Plaza. As consideration for being permitted to participate in the Event and to use the premises and facilities, I forever release CCFSC, Loma Linda University Medical Center, any affiliated organization, and their respective directors, officers, employees, volunteers, agents, contractors, and representatives (collectively “Releasees”) from any and all actions, claims, or demands that I, my assignees, heirs, distributees, guardians, next of kin, spouse and legal representatives now have or may have in the future, for injury, death or property damage, related to (i) my participation in the Event, (ii) the negligence or other acts, whether directly connected to the Event or not, and however caused, by any Releasee, or (iii) the condition of the premises where these activities occur, whether or not I am then participating in the Event. I also agree that I, my assignees, heirs, distributees, guardians, next of kin, spouse and legal representatives will not make any claim against, sue, or attach the property of any Releasee in connection with any of the matters covered by the foregoing release. I AM AWARE THAT THESE ACTIVITIES CAN BE HAZARDOUS AND THAT I COULD BE INJURED. I AM VOLUNTARILY PARTICIPATING IN THESE ACTIVITIES WITH THE KNOWLEDGE OF THE DANGER INVOLVED, AND AGREE TO ASSUME ANY AND ALL RISKS OF BODILY INJURY, DEATH OR PROPERTY DAMAGE, WHETHER THOSE RISKS ARE KNOWN OR UNKNOWN. I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY NDERSTAND ITS CONTENTS. I AM AWARE THAT IT IS A FULL RELEASE OF LIABILITY AND SIGN IT OF MY OWN FREE WILL. VOLUNTEER SIGNATURE:
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PARENT SIGNATURE (Must be signed by parent if under 18 years of age)
If signed by Parent or Guardian: I verify that the dangers of the activities and the significance of this Release and Waiver were explained to the Participant and that the Participant understood them.
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