[Organization Name]
[Address]
[Phone Number]
[Email Address]
Date: [Date]
Volunteer: [Volunteer Name] (Print)
Address: [Volunteer Address] (Print)
Phone Number: [Volunteer Phone Number] (Print)
Emergency Contact: [Emergency Contact Name] (Print)
Emergency Contact Phone Number: [Emergency Contact Phone Number] (Print)
Activity: [Describe the volunteer activity]
In consideration of being allowed to participate in the volunteer activities (the "Activity") of [Organization Name] (the "Organization"), I, the undersigned, hereby agree to the following:
1. Release and Waiver of Liability:
I understand that volunteering involves inherent risks, including but not limited to:
I hereby release, waive, discharge, and covenant not to sue the Organization, its directors, officers, employees, volunteers, agents, representatives, successors, and assigns (collectively, the "Released Parties") from any and all claims, demands, losses, or liabilities arising out of or in any way connected with my participation in the Activity, including but not limited to personal injury, property damage, wrongful death, or illness.
2. Medical Treatment Authorization:
In the event of an emergency, I authorize the Released Parties to secure medical treatment for me at my expense. I understand that I am responsible for the cost of any medical treatment I receive.
3. Assumption of Risk:
I acknowledge that I have read and understand the terms of this Volunteer Waiver and Release of Liability Form. I assume full responsibility for any risks, injuries, or damages I may sustain while participating in the Activity.
4. Medical Conditions:
I disclose that I have the following medical conditions (if any): [List any medical conditions]. I acknowledge that I am physically and mentally fit to participate in the Activity.
5. Photography and Video Release:
I grant the Organization the right to use photographs or video footage of me taken during the Activity for promotional or educational purposes.
6. Governing Law:
This Volunteer Waiver and Release of Liability Form shall be governed by and construed in accordance with the laws of the State of [State].
7. Entire Agreement:
This Volunteer Waiver and Release of Liability Form constitutes the entire agreement between me and the Organization with respect to the subject matter hereof and supersedes all prior or contemporaneous communications, representations, or agreements, whether oral or written.
8. Severability:
If any provision of this Volunteer Waiver and Release of Liability Form is held to be invalid or unenforceable, such provision shall be struck and the remaining provisions shall remain in full force and effect.
[Volunteer Signature]
[Date]
[Parent or Guardian Signature (if under 18)]
Please note: This is a sample Volunteer Waiver and Release of Liability Form and may not be suitable for all situations. You are encouraged to consult with an attorney to ensure that the form is appropriate for your organization's needs.
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