Participant Release and Waiver of Liability
NOTE: Minors (under the age of 18) must complete this form with a Parent or Legal Guardian.


The Momentum Group dba Create Common Good (hereafter CCG), a 501(c)(3) non-profit organization organized and existing under the laws of the State of Oregon, is a program, whose mission is to provide job training and placement for persons with barriers to employment with the ultimate goal of self sufficiency. CCG also operates a food manufacturing facility to assist in the financial support of the organization’s mission.

I, the participant (volunteer, trainee, intern, or anyone not employed by CCG who participates in CCG activities), execute this Participant Release and Waiver of Liability in favor of CCG and it’s boards of directors, officers, employees, interns and volunteers . A participant desires to perform services for and with CCG on a volunteer basis. The Participant understands he/she may be working with persons with barriers to employment (e.g., refugees & immigrants, persons exiting the prison system, persons exiting substance abuse programs, women rebuilding their lives post domestic violence, persons who are chronically homeless).

The participant freely and voluntarily, without duress, executes this Release under the following terms:

Waiver and Release. The Participant releases and forever discharges and hold harmless CCG from any claim or liability that the Participant may have against Create Common Good with respect to any bodily injury, personal injury, illness, death or property damage that may result from participation in CCG’s operations. The Participant also understands that CCG does not assume any responsibility or obligation to provide financial or other assistance, including but not limited to: medical, health or disability insurance or care, in the event of injury, illness, death or property damage (see insurance requirements below)

Insurance. CCG does not carry or maintain, and expressly disclaims responsibility for providing any type of insurance, including but not limited to health, medical, disability, vehicle or liability insurance coverage for the Participant. EACH PARTICIPANT IS EXPECTED AND ENCOURAGED TO CARRY APPLICABLE INSURANCE PRIOR TO VOLUNTEERING WITH CCG. The Participant understands that he/she will be responsible (either covered by personal medical insurance, or personal finances) for any costs associated with a personal injury or illness.

Medical Treatment. Except as otherwise agreed to by CCG in writing and signed by the Chief Operating Officer, the Participant hereby releases and forever discharges CCG 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 the Participant’s time with CCG.

Assumption of Risk. The Participant understands that his/her time with CCG may include activities that may be hazardous to the Participant such as driving, working at the CCG Farm, working in the CCG production kitchen, etc., and will not hold CCG accountable or liable for any injury that unintentionally result from or that arises during time spent participating in CCG activities due to any underlying physical condition.

The Participant understands that inherent risks may be associated with activities at the CCG farm, including but not limited to cuts from using gardening implements (hoes, shovels, machetes and other garden hand tools), insect bites, injury due to contact with animals (rabbits, gophers, rock chucks, snakes – including rattlesnakes), sunburn, heat related illness (heat stroke, dehydration, heat exhaustion, heat rash), allergic reactions, injury due to uneven terrain (including sprained ankle, broken bones), scrapes, abrasions, splinters, blisters, paralysis and death.

The Participant also understands that inherent risks may be associated with activities at the CCG Production Kitchen, including but not limited to cuts from using kitchen equipment (knives, hand tools, choppers, etc.), insect bites, burns from contact with equipment (stoves, ovens, hot pans, etc.), allergic reactions, injury due to slips, trips or falls (including sprained ankle, broken bones), scrapes, abrasions, splinters, blisters, paralysis and death.

Compensation. Participant understands that Create Common Good is a volunteer organization and that Participant is not acting as an employee of Create Common Good and will not receive compensation.

Initial if you understand and agree to the statements above.
If the Participant is a minor, a Parent or Legal Guardian initial here instead.
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