Adult Volunteer Waiver Form 2019-2020
Welcome to the AHA Adult Volunteer Waiver Form!
AHA STAFF MEMBERS ONLY: You are required to have the Pennsylvania Child Abuse History Clearances (CY113) and the Pennsylvania Criminal Record Checks for Volunteers (SP4-164A). If you do not have these two certifications, please obtain them here:
Upon filling out this form, we will reach out to get these clearances from you.
Please complete the form below and hit 'Submit' at the end. Thank you for registering.
Volunteer's Last Name
Volunteer's First Name
Date of Birth
What school district do you currently live in?
By checking in the box below, I agree to the terms described in the Athletes Helping Athletes, Inc. Scholastic Waiver Form.This Waiver Form is valid for the entire 2019-20 Calendar School Year of Games and Events.
The foregoing document is a Release and Waiver of Liability (the “Release”), which is executed on the the date listed below and by the person listed below (the “Volunteer”), in favor of Athletes Helping Athletes, Inc., a Pennsylvania non-profit corporation, their officers, employees, and agents (collectively, “AHA”).In conjunction with signing the document, the Volunteer acknowledges and desires to work as a volunteer for AHA and participate in the accompanying activities. The Volunteer acknowledges that many activities require physical participation and exertion and the Volunteer states that the Volunteer is participating in these activities knowingly, freely, voluntarily, and, without duress, executes the release subject to the conditions listed below:1.Volunteer does hereby release and forever discharge and hold harmless AHA and its successors and assigns 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 Volunteer’s activities with AHA. Volunteer understands that this release discharges AHA from any liability or claim that the Volunteer may have against AHA with respect to any bodily injury, personal injury, illness, death or property damage that may result from Volunteer’s Activities with AHA, whether caused by the negligence of AHA or its officers, directors, employees, agents or otherwise. Volunteer also understands that AHA does not assume any responsibility for or obligation to provide financial assistance or other assistance, including but not limited to medical, health, or disability insurance in the event of injury or illness. 2. Volunteer acknowledges that participation with AHA will likely require periods of time where physical exertion is necessary. Volunteer further acknowledges that participation in these activities is voluntary and that Volunteer will exercise reasonable care to avoid injury and will accept any and all risks of personal injury and property damage. Volunteer hereby expressly and specifically assumes the risk of injury or harm in the Activities and releases AHA from all liability for injury, illness, death, or property damage resulting from the Activities. 3.Volunteer acknowledges that if Volunteer is injured in the course of volunteering with AHA that Volunteer is not covered by any Workers’ Compensation Program. Volunteer authorizes AHA to seek emergency medical treatment on Volunteer’s behalf, if necessary, with respect to injuries or illness sustained as a result of any involvement with AHA. Volunteer is aware that Volunteer is responsible for medical costs incurred by such accident, illness, or injury. Volunteer does hereby release and forever discharge AHA from any claim whatsoever which arises or may hereafter arise on account of any first aid, treatment, or service rendered in connection with the Volunteer’s Activities with AHA. 4.Volunteer expressly agrees that this Release is intended to be as broad and inclusive as permitted by the laws of the Commonwealth of Pennsylvania, and that this Release shall be governed by and interpreted in accordance with the law of the Commonwealth of Pennsylvania. Volunteer agrees that in the event that any clause or provision of this Release shall be held to be invalid by any court of competent jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining provision of this Release which shall continue to be enforceable. 5.Volunteer acknowledges that Volunteer has carefully read this agreement and fully understands its contents. Volunteer is aware that this is a RELEASE OF LIABILITY, and has so executed this document of Volunteer’s own free will.
I agree to these terms.
Please type full name.
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