York Fresh Food Farms Volunteer Form
York Fresh Food Farms Registration and Release Form for 2021 Season
Email address *
First & Last Name *
Birth date *
Mobile # *
Emergency Contact Name, Relationship *
Emergency Contact # *
Please List any Comments, Concerns, Special Needs, or Limitations
Please List any Applicable Interests, Skills, Training or Experience
Availability *
Task Preference: *
Are you able to commit on a weekly or biweekly basis in return for a food share?
Clear selection
Terms of Agreement
DEFINITION. As used herein “Released Persons” are: York Fresh Food Farms, The Housing Authority of the City of York,
TrueNorth Wellness Services, the Redevelopment Authority of the City of York, the United Way of York County, Annalisa Gojmerac and their respective agents, representatives, employees, officers, volunteers and/or invitees, jointly, severally, and individually.
In consideration of registering, volunteering and/or participating in activities with York Fresh Food Farms, I agree as follows:

1. WAIVER AND RELEASE: I, the Volunteer, release and forever discharge and hold harmless the Released Persons from any
and all liability, claims, and demands of whatever kind or nature, either in law or in equity, which arise, or may hereafter arise, from the services I provide or any activity for York Fresh Food Farms in which I participate. I understand and acknowledge that this Release discharges any liability or claim that I may have for bodily or personal injury, illness, death, or property damage.

2. MEDICAL TREATMENT: I hereby release and forever discharge the Released Persons from any claim whatsoever that arises
or may hereafter arise on account of any first-aid treatment or other medical services rendered in connection with an emergency
during my time as a volunteer.

3. ASSUMPTION OF RISKS: I understand that the services I provide to, and the activities I participate in at, for or with York Fresh
Food Farms may include activities that are hazardous or inherently dangerous. As a volunteer, I hereby expressly assume the risk of injury or harm from these activities and release the Released Persons from all liability for injury, illness, death, or property
damage resulting from the services I provide as a volunteer or occurring in connection with any York Fresh Food Farms activities.

4. PHOTOGRAPHIC RELEASE: I consent to and allow York Fresh Food Farms, its agents, representatives, employees, officers,
volunteers, sponsors and/or others (a) to take photographs and/or video of me and (b) to use, reproduce and distribute any and all images, photographs, video and/or audio of me. I understand that York Fresh Food Farms will own the images, photographs, video and audio and the right to use, reproduce, distribute, sell, assign, transfer or exhibit, for profit or otherwise, such photo- graphs, images, video and audio, as well as the right to edit them or prepare derivative works, for the purposes of promotion, advertising, public relations or education. I hereby consent to York Fresh Food Farms’ use of my name, likeness and/or voice, and I agree that such use will not result in any liability to York Fresh Food Farms for payment to any person or entity whatsoever.

5. As a volunteer, I expressly agree that this Release is intended to be as broad and inclusive as permitted by Pennsylvania law
and that this Release shall be governed by and interpreted in accordance with Pennsylvania law. I agree that if any clause or
provision of this Release is deemed invalid, the enforceability of the remaining provisions shall not be affected.
By signing below, I intend, for myself, my successors and assigns, to be legally bound hereby and to enter into this
Volunteer Registration and Release willingly and voluntarily.

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Signature of Volunteer & Date Signed *
Signature of Volunteer's Parent or Guardian if Under 18 & Date Signed
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