Waiver
In consideration for being permitted by the Pleasant Valley Recreation & Park District (“District”) to participate in this volunteer assignment/ activity, I hereby waive, release, and discharge any and all claims for damages for personal injury, death, or property damage which I may have, or which may hereafter accrue to me, as a result of participation in the assignment/activity. This release is intended to discharge in advance the District (including its officers, employees, volunteers, and agents) from any and all liability arising out of or connected in any way with my participation in said activity, even though that liability may arise out of active or passive negligence or carelessness on the part of the persons or entities mentioned above.
I understand that photography and video may be taken during this activity and hereby grant the District permission to use any such photo(s) for advertising or in promotional materials.
It is further agreed that this waiver, release, and assumption of risk is to be binding on my heirs. administrators, executors, and assigns. I agree to indemnify and to hold District, (including its officers, employees, volunteers, and agents) free and harmless from any loss, liability, damage, cost, or expense which may arise out of or connected in any way with my participation in the volunteer assignment/activity.
I fully understand that my participation in this volunteer assignment/activity exposes me to the risk of personal injury, death, communicable diseases, illnesses, viruses, and/or property damage. I hereby acknowledge that I am voluntarily participating in this activity and agree to assume any such risks.
I certify that all statements on this application are true and correct to the best of my knowledge. I understand that the information I provide may be verified, and I give permission to the District to make inquiry of others concerning my suitability to act as a volunteer. I also understand that a Livescan fingerprint background check may be required if the action is deemed necessary for a volunteer assignment. I understand that any false statements will disqualify me from the District’s volunteer program.
I am aware that the relationship between the District and a volunteer is “at will” in nature, and that it may be terminated at any time without cause by either the volunteer or the District. Further, I understand that as a volunteer, I am offering my services of my own free will without any expectation of compensation, health or life insurance, or other employee benefits of any kind. I understand that filling out a volunteer interest form does not promise a volunteer assignment with the District. I understand that as a volunteer for the district, I am not now and will not become an employee of the district and have no employment rights of any kind. Finally, I agree to comply with all District rules and guidelines as well as all applicable public health rules, regulations, orders, and/or guidance in effect at the time of my participation in this volunteer activity.
I hereby further acknowledge that I am not an employee of the District, but that I am covered under the Agency's workers' compensation plan since the District has adopted a resolution extending workers' compensation coverage to certain volunteers in specified categories pursuant to Labor Code Section 3363.5.
As a volunteer who is covered under the District’s workers' compensation plan, I expressly agree and acknowledge that workers' compensation is my exclusive remedy for any injury suffered while performing said volunteer duties, and that I cannot and will not seek to bring any other claim or actions of any type whatsoever against the District, its employees, officers, agencies, other volunteers and officials.
I HAVE CAREFULLY READ THIS AGREEMENT, WAIVER, AND RELEASE AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN MYSELF AND THE ABOVE DISTRICT AND I SIGN IT OF MY FREE WILL. I UNDERSTAND THE WAIVER IS REQUIRED TO BE COMPLETED FOR EVERY VOLUNTEER SIGN UP.
In consideration for being permitted by the Pleasant Valley Recreation & Park District (“District”) to participate in this volunteer assignment/ activity, I hereby waive, release, and discharge any and all claims for damages for personal injury, death, or property damage which I may have, or which may hereafter accrue to me, as a result of participation in the assignment/activity. This release is intended to discharge in advance the District (including its officers, employees, volunteers, and agents) from any and all liability arising out of or connected in any way with my participation in said activity, even though that liability may arise out of active or passive negligence or carelessness on the part of the persons or entities mentioned above.
I understand that photography and video may be taken during this activity and hereby grant the District permission to use any such photo(s) for advertising or in promotional materials.
It is further agreed that this waiver, release, and assumption of risk is to be binding on my heirs. administrators, executors, and assigns. I agree to indemnify and to hold District, (including its officers, employees, volunteers, and agents) free and harmless from any loss, liability, damage, cost, or expense which may arise out of or connected in any way with my participation in the volunteer assignment/activity.
I fully understand that my participation in this volunteer assignment/activity exposes me to the risk of personal injury, death, communicable diseases, illnesses, viruses, and/or property damage. I hereby acknowledge that I am voluntarily participating in this activity and agree to assume any such risks.
I certify that all statements on this application are true and correct to the best of my knowledge. I understand that the information I provide may be verified, and I give permission to the District to make inquiry of others concerning my suitability to act as a volunteer. I also understand that a Livescan fingerprint background check may be required if the action is deemed necessary for a volunteer assignment. I understand that any false statements will disqualify me from the District’s volunteer program.
I am aware that the relationship between the District and a volunteer is “at will” in nature, and that it may be terminated at any time without cause by either the volunteer or the District. Further, I understand that as a volunteer, I am offering my services of my own free will without any expectation of compensation, health or life insurance, or other employee benefits of any kind. I understand that filling out a volunteer interest form does not promise a volunteer assignment with the District. I understand that as a volunteer for the district, I am not now and will not become an employee of the district and have no employment rights of any kind. Finally, I agree to comply with all District rules and guidelines as well as all applicable public health rules, regulations, orders, and/or guidance in effect at the time of my participation in this volunteer activity.
I hereby further acknowledge that I am not an employee of the District, but that I am covered under the Agency's workers' compensation plan since the District has adopted a resolution extending workers' compensation coverage to certain volunteers in specified categories pursuant to Labor Code Section 3363.5.
As a volunteer who is covered under the District’s workers' compensation plan, I expressly agree and acknowledge that workers' compensation is my exclusive remedy for any injury suffered while performing said volunteer duties, and that I cannot and will not seek to bring any other claim or actions of any type whatsoever against the District, its employees, officers, agencies, other volunteers and officials.
I HAVE CAREFULLY READ THIS AGREEMENT, WAIVER, AND RELEASE AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN MYSELF AND THE ABOVE DISTRICT AND I SIGN IT OF MY FREE WILL. I UNDERSTAND THE WAIVER IS REQUIRED TO BE COMPLETED FOR EVERY VOLUNTEER SIGN UP.
PARENTAL/GUARDIAN CONSENT: (to be completed and signed by parent/guardian if Volunteer is under 18 years of age.)
In consideration for being permitted by the Pleasant Valley Recreation & Park District (“District”) to participate in this volunteer assignment/ activity, I hereby waive, release, and discharge any and all claims for damages for personal injury, death, or property damage which I may have, or which may hereafter accrue to me, as a result of participation in the assignment/activity. This release is intended to discharge in advance the District (including its officers, employees, volunteers, and agents) from any and all liability arising out of or connected in any way with my participation in said activity, even though that liability may arise out of active or passive negligence or carelessness on the part of the persons or entities mentioned above.
I understand that photography and video may be taken during this activity and hereby grant the District permission to use any such photo(s) for advertising or in promotional materials.
It is further agreed that this waiver, release, and assumption of risk is to be binding on my heirs. administrators, executors, and assigns. I agree to indemnify and to hold District, (including its officers, employees, volunteers, and agents) free and harmless from any loss, liability, damage, cost, or expense which may arise out of or connected in any way with my participation in the volunteer assignment/activity.
I fully understand that my participation in this volunteer assignment/activity exposes me to the risk of personal injury, death, communicable diseases, illnesses, viruses, and/or property damage. I hereby acknowledge that I am voluntarily participating in this activity and agree to assume any such risks.
I certify that all statements on this application are true and correct to the best of my knowledge. I understand that the information I provide may be verified, and I give permission to the District to make inquiry of others concerning my suitability to act as a volunteer. I also understand that a Livescan fingerprint background check may be required if the action is deemed necessary for a volunteer assignment. I understand that any false statements will disqualify me from the District’s volunteer program.
I am aware that the relationship between the District and a volunteer is “at will” in nature, and that it may be terminated at any time without cause by either the volunteer or the District. Further, I understand that as a volunteer, I am offering my services of my own free will without any expectation of compensation, health or life insurance, or other employee benefits of any kind. I understand that filling out a volunteer interest form does not promise a volunteer assignment with the District. I understand that as a volunteer for the district, I am not now and will not become an employee of the district and have no employment rights of any kind. Finally, I agree to comply with all District rules and guidelines as well as all applicable public health rules, regulations, orders, and/or guidance in effect at the time of my participation in this volunteer activity.
I hereby further acknowledge that I am not an employee of the District, but that I am covered under the Agency's workers' compensation plan since the District has adopted a resolution extending workers' compensation coverage to certain volunteers in specified categories pursuant to Labor Code Section 3363.5.
As a volunteer who is covered under the District’s workers' compensation plan, I expressly agree and acknowledge that workers' compensation is my exclusive remedy for any injury suffered while performing said volunteer duties, and that I cannot and will not seek to bring any other claim or actions of any type whatsoever against the District, its employees, officers, agencies, other volunteers and officials.
I hereby consent that my son/daughter, participate as a volunteer in the above-referenced activity, and I hereby execute the above Agreement, Waiver, and Release on his/her behalf. I state that said minor is physically able to participate in said activity. I hereby agree to indemnify and hold the District (including its officers, employees, volunteers, and agents) free and harmless from any loss, liability, damage, cost, or expense which may arise out of or connected in any way with said minor’s participation in said activity.
I HAVE CAREFULLY READ THIS AGREEMENT, WAIVER, AND RELEASE AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN MYSELF AND THE ABOVE DISTRICT AND I SIGN IT OF MY FREE WILL. I UNDERSTAND THE WAIVER IS REQUIRED TO BE COMPLETED FOR EVERY VOLUNTEER SIGN UP.
