Child Life Disaster Relief Volunteer Liability Form
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Email *
By clicking the box below, I (herein “Participant”), express my wish to participate in disaster relief work (herein the “Activity”) facilitated by Child Life Disaster Relief, a non –profit (Herein the “Organization”) and do so of my own free will. *
Required
Participant acknowledges that he/she has received a job description and accepts all duties and risks inherent to Activity.  Activity happens throughout the year; before, during and following disasters.  Organization and Participant agree that the Activity poses potential “Risks”. “Risks'' include, but are not limited to, the following: emotional, mental, or physical injury to Participant or Participant’s property when traveling by plane, bus, train, car, truck, van, or any other vehicle; other general risks to Participant or property associated with travel; encountering or experiencing sickness, illness, disease, accident, emotional, mental, or physical injury to Participant’s person or even Participant’s death as a result of any actions relating to the Activity; loss, destruction or damage to Participant’s personal property as a result of any actions relating to the Activity;  emotional, mental, or physical injury to Participant as a result of exposure to emotionally disturbing conditions; emotional, mental, or physical injury to Participant as a result of exposure to harsh, extreme or substandard conditions; emotional, mental, or physical injury to Participant as a result of crime; any and all inherent risks associated with any Recreational Activity in which the Participant participates throughout the duration of the Activity; or any and all inherent risks with domestic/local/international travel including, but not limited to: political instability; rioting; natural disasters; lack of electricity, running water, or sewage and supplies; harsh sleeping conditions; evacuation from the Activity location; and lack of access to medical care. Participant acknowledges that Activity may be unsafe and he/she may work in dangerous and possibly unstable locations and with clients who may be physically, emotionally and/or mentally harmed and therefore Participant assumes all inherent risks associated with these locations and clients. *
Required
Participant and Participant’s personal representatives, assigns, heirs, distributes, guardians and next of Kin (herein the “Releasors”) release, waive, discharge and forever hold harmless Organization and it’s officers, employees, and agents (herein the “Releasees”) from all claims, accidents, injuries to Participant or death to Participant or injuries to the property of the Participant, whether caused by the negligence of Releasees or otherwise, while Participant is participating in the Activity or as a result of Participant's involvement in Activity. Participant shall defend, hold harmless, and indemnify Organization, its board, employees, agents, and other volunteers from and against, including but not limited to, all claims, accusations, notices, judgments, rulings, liabilities, and expenses that may exist as a result of his/her actions, inactions, errors, acts, or omissions. *
Required
Participant is fully aware of the Risks and other hazards inherent in the Activity and voluntarily assumes the Risks and all other Risks of loss, damage, or injury (whether physical, emotional, or mental) that may be sustained by the Participant while participating in the Activity. Releasors acknowledge that as a part of this Release they shall be entirely liable to pay for all medical expenses resulting or to result from any injury incurred during, or as a result of, Participant’s contribution to the Activity.  Releasors also acknowledge that Organization is not liable for any and all injuries (including but not limited to physical, mental and emotional injuries) that result from having received first aid or other treatment from Organization. Participant represents that, to his/her knowledge, she/he is in good health and suffers no physical impairment that would or should prevent participation in Activities.  Organization will not provide health insurance or disability payments for Participant for any reason, nor is Participant covered under workers' compensation as a result of Participant's involvement in Activity. *
Required
Furthermore, Participant understands that Participant’s voice or image may be recorded at this Activity or in travel to and from the Activity location. Participant irrevocably grants to Organization the perpetual, royalty-free license and permission to use, reuse, publish, republish Participant’s voice, likeness and photograph, and to the extent provided by Participant, name and biography, as included in video or audio recordings or photographs from the event, in whole or in part, at Organization’s sole discretion, in conjunction with Organization’s Uses and promotion thereof. Organization’s Uses include, but are not limited to, DVDs, photographs, cassettes, compact discs, transcripts and publications in written, electronic, digital and other formats now existing or later developed for sale, license, distribution, transmission or posting or download from the Internet. *
Required
Participant warrants that he/she has fully read and understands this Volunteer Waiver & Release and voluntarily signs the same, and that no oral representations, statements or inducements apart from the foregoing written agreement have been made to Participant. This agreement shall be as broad and inclusive as permitted by the laws of the State in which the Participant resides and the State in which the Participant performs their duties for the Organization.  Participant agrees that if any portion of this Agreement is invalid, the remainder will continue in full legal force and effect. *
Required
By signing this form, I acknowledge that I have read and understood the terms and conditions above in their entirety.
Full Name (First Last) *
Signature *
By signing this form, I acknowledge that I have read, understood, and agreed to the terms and conditions above in their entirety and that the information given is true and correct. Use the green button at the top left of the page to accept the terms and conditions of the Volunteer Liability Form with a signature.
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