Volunteer Release and Waiver
PLEASE READ CAREFULLY!
THIS IS A LEGAL DOCUMENT THAT AFFECTS YOUR LEGAL RIGHTS!
Trip Date: ____________________
This Release and Waiver of Liability (the "Release") is executed by _______________ (the "Volunteer"), in favor of Adopta Una Familia, Inc., a Connecticut nonprofit corporation, its directors, officers, employees, and agents (collectively "AUF").
The Volunteer desires to work as a volunteer for AUF and to engage in the activities related to being a volunteer (the "Activities"). The Volunteer understands that the Activities include constructing homes and doing related building work in Ecuador.
It is the policy of AUF, Inc. to provide as safe a workplace as possible realizing that a construction and building site has many inherent safety hazards.
The Volunteer hereby freely, voluntarily, and without duress executes this Release under the following terms:
Release and Waiver. Volunteer hereby releases and forever discharges and holds harmless AUF and its successors and assigns from 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 AUF. Volunteer understands that this Release discharges AUF from any liability or claim that the Volunteer may have against AUF with respect to any bodily injury, personal injury, illness, death or property damage that may result from Volunteer's Activities with AUF, whether caused by the negligence of AUF or its directors, officers, employees, agents or otherwise. AUF also understands that AUF 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.
Medical Treatment. Volunteer hereby releases and forever discharges AUF from any claim whatsoever which arises or may hereafter arise on account of any first aid, medical treatment, or service rendered in connection with the Volunteer's Activities with AUF.
Assumption of the Risk. The Volunteer understands that the Activities include work that may be hazardous to the Volunteer. Volunteer hereby expressly and specifically assumes the risk of injury or harm in the Activities and releases AUF from all liability for injury, illness, death or property damage resulting from the Activities.
Insurance. AUF requires the Volunteer to provide proof of medical insurance. Insurance for the trip can be obtained at Trip Guard.com. AUF does not provide medical insurance to Volunteers.
Photographic Release. Volunteer grants and conveys unto AUF all right, title, and interest in any and all photographic images and video or audio recordings made by AUF during the Volunteer's Activities with AUF, including, but not limited to, any royalties, proceeds, or other benefits derived from such photographs or recordings.
Other. Volunteer expressly agrees that this Release is intended to be as broad and inclusive as permitted by the laws of the State of Connecticut. This Release shall be governed by and interpreted in accordance with the laws of the State of Connecticut. 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.
I have read and understand the above provisions and I agree to abide by them.
Home Phone: __________________________
Work Phone: __________________________
Mobile Phone: _________________________
Age Range: (circle) under 18 18 and over
Volunteer Signature: ____________________ Date: __________
Witness Signature, or if under 18, Parent/Guardian signature: ____________________ Date: __________
Emergency Contact Name: ____________________ Relationship: __________
Emergency Contact Telephone Number(s): ____________________
ADD ANY OTHER ADDITIONAL AND/OR PERTINENT INFORMATION: