THE GRACE THOMAS FOUNDATION VOLUNTEER FORM

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First Name *

Last Name *

Email *

Address *

Phone number

Emergency Contact name and Phone number

Do you have any certification on First Aid or Safe Food handling or related certificate. (If Yes please write below)

waiver

Option 1

I hereby assume all of the risks of participating in this duty. I certify that I am physically fit and have not been advised otherwise by a qualified medical person not to participate in this service. In consideration of my application and permitting me to participate in this program, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A) Waive, release, and discharge from any and all liability from this event, The Grace Thomas Foundation, its employees and volunteers, (B) indemnify and hold harmless all entities or persons mentioned in this paragraph from any and all liabilities or claims made by other individuals or entities as a result of my actions during this event. I understand that at this event or related activities I may be photographed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by the event holders, sponsors, affiliate or organizers. This AWRL shall be construed broadly to provide a release and waiver to the maximum extent permissible under the applicable law. I hereby certify that I have read this document and I understand its content. *

YES

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Email *

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Phone number

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