Girls Rock Austin Volunteer Media Release & Liability Acceptance Form (scroll to complete)
This Release and Waiver of Liability (the “release”) executed on the day of the submission of this application by the volunteer releases Girls Rock Austin, a nonprofit corporation organized and existing under the laws of the State of Texas and each of its directors, officers, employees, and agents. The Volunteer desires to provide volunteer services for Nonprofit and engage in activities related to serving as a volunteer.
I, as a Volunteer understands that the scope of Volunteer’s relationship with Girls Rock Austin is limited to a volunteer
position and that no compensation is expected in return for services provided by Volunteer, that Girls Rock Austin will not provide any benefits traditionally associated with employment to Volunteer; and that Volunteer is responsible for his/her own insurance coverage in the event of personal injury or illness as a result of Volunteer’s services to Nonprofit.
1. Waiver and Release: I, the Volunteer, release and forever discharge and hold harmless Girls Rock Austin and its successors and assigns from any and all liability, claims, and demands of whatever kind of nature, either in law or in equity, which arise or may hereafter arise from the services I provide to Nonprofit. I understand and acknowledge that this Release discharges Nonprofit from any liability or claim that I may have against Nonprofit with respect to bodily injury, personal injury, illness, death, or property damage that may result from the services I provide to Nonprofit or occurring while I am providing volunteer services.
2. Insurance: Further I understand that Girls Rock Austin does not assume any responsibility for or obligation to provide me with financial or other assistance, including but not limited to medical, health, or disability benefits or insurance. I expressly waive any such claim for compensation or liability on the part of Nonprofit beyond what may be offered freely by Nonprofit in the event of injury or medical expenses incurred by me.
3. Medical Treatment: I hereby Release and forever discharge Girls Rock Austin from any claim whatsoever which arises or may hereafter arise on account of any first-aid treatment or other medical services rendered in connection with an emergency during my tenure as a volunteer with Girls Rock Austin.
4. Assumption of Risk: I understand that the services I provide to Girls Rock Austin may include activities that may be hazardous to me including, but not limited to lifting, gear or other inherently dangerous activities. As a volunteer, I hereby expressly assume risk of injury or harm from these activities and Release Nonprofit from all liability.
5. Photographic Release: I grant and convey to Girls Rock Austin all right, title, and interests in any and all photographs, images, video, or audio recordings of me or my likeness or voice made by Nonprofit in connection with my providing volunteer services to Nonprofit. I further grant permission to Girls Rock Austin, its agents and assigns, to use my name, voice, photo, video, interview, performance and likeness for promotion of Girls Rock Austin camps, programs, and events for all forms, media and manners, including, but not limited to footage, videos, audio recording, promotional pieces, documentaries, DVDs, documentaries, news releases, photographs, website, internet mediums, marketing, advertising, trade, promotion, and exhibition for an indefinite period of time. I give unrestricted permission for images, videos, and recordings of myself to be used in print, video, digital, and internet media in whole or in part. I agree that these images and/or voice recordings may be used for a variety of purposes and that these images may be used without further notifying me. Girls Rock Austin shall own all rights, title, and interest in and to the Media Images, to be used an disposed of at the discretion of Girls Rock Austin. I acknowledge that neither the child nor I will be compensated for the use of these Media Images.
6. Other: As a volunteer, I expressly agree that this Release is intended to be as broad and inclusive as permitted by the laws of the State of Texas and that this Release shall be governed by and interpreted in accordance with the laws of the State of Texas. I agree that in the event that any clause or provision of this Release is deemed invalid, the enforceability of the remaining provisions of this Release shall not be affected.
By submitting the information requested below, I express my understanding and intent to enter into this Release and Waiver of Liability willingly and voluntarily.
Name of Volunteer (First and Last):
Acceptance: Media Release
I do not agree
Acceptance: Liability Acceptance
Which sessions will you be volunteering?
GRA Rock Retreat: Saturday, February 15th - Monday, February 17th
Session 1: Monday, July 13th - Friday, July 17th, (setup and orientation July 12th, showcase July 18th)
Session 2: Monday, July 20th - Friday, July 24th, (setup and orientation July 19th, showcase July 25th)
A copy of your responses will be emailed to the address you provided.
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