Volunteer Release, Waiver of Liability

Volunteer Release, Waiver of Liability

and Indemnity Agreement

CAUTION: This form is a contract with legal consequences. Read it carefully and completely before signing. Its effect is to release the Vestavia Hills Chamber of Commerce and the City of Vestavia Hills from any liability resulting from participation in volunteer activities and projects and to waive all claims for damages or losses against such organizations.

I, the undersigned, wish to volunteer my services to various community service organizations and projects through you, Vestavia Hills Chamber of Commerce, an Alabama nonprofit corporation, and the City of Vestavia Hills, a municipality organized under the laws of the State Alabama (hereinafter both organizations, along with their respective officers, directors, employees, agents, sponsors, donors, successors, heirs and assigns,are referred to as the “Released Parties”). In consideration of your locating, arranging, coordinating and/or making available volunteer opportunities, I hereby agree and release you as follows:

I acknowledge and agree that the nature of the volunteer services which are typically performed by Released Parties’ volunteers, and which may be performed by me as a volunteer on Released Parties’ projects, may involve (a) physical activity and occur in potentially dangerous weatherconditions, including hot or inclement weather, which could cause injury, property damage, or even death and canbe physically, mentally, and emotionally demanding, (b) contact with dangerous and hazardous materials and objects and working with heavy tools and materials, (c)contact with unidentified and unfamiliar persons, (d) travel to and from various unspecified locations, and (e) other potential risk of injury. Notwithstanding the preceding sentence, I willingly and freely agree to volunteer and hereby assume any and all risk, with respect to any liability of Released Parties for such risk, including without limitation risk of any accident or injury to person or property which I may sustain in connection with my participation as a Released Parties volunteer or in any Released Parties project or activity.

I fully realize the dangers of the volunteer activities and projects of Released Parties and Ifully assume all risks of bodily injury, death or property damage which may result from my participation in such activities and projects, including, for example, the following: potentially dangerous property conditions andweather conditions, equipment defects or failure, lack of supervision, and the possibility of serious physicalinjury. I have no physical or medical condition which, to my knowledge, would endanger myself or others if Iparticipate in theseactivities and projects. I understand and accept that the Released Parties cannot and do not assume responsibilityfor any aspect of my safety, and that if I participate in theseactivities and projects, I do so voluntarily on myown assessment of my ability, the other participants and conditions, assuming all risk.

I am familiar with the safeoperation and use of equipment or tools that I may use in connection with these activities and projects and I willnot use any equipment or tools with which I am not familiar or do not know how to operate safely. I will notundertake any tasks that are beyond my physical ability to perform.

In case of emergency involving me, I hereby give my permission to any medicalprovider to secure proper treatment, including hospitalization, anesthesia, surgery, or injections of medication forme. Medical providers are authorized to disclose to the Released Parties, examination findings, test results, and treatmentprovided for purposes of medical evaluation.

I acknowledge and agree that I am acting as an uncompensated volunteer at my request and risk,on my own behalf, and not as an official, officer, employee, agent, contractor or other representative of the Released Parties.I understand that I am not entitled to any compensation, benefits or insurance coverage from or by the Released Partiesin connection with my participation as a Released Parties volunteer or in any Released Parties project or activity and I will not make any claim for such.

I hereby release the Released Parties from and covenant not to sue the Released Parties for, any and all claims and causes of action, whether known or unknown, arising out of, based upon or relating to my participation as a Released Parties volunteer or in any Released Parties activity or project, and I agree to indemnify and hold harmless the Released Partiesfrom anyloss, liability, damage or cost I may incur in connection with the activities and projects whether caused by the negligence ofthe Released Parties or otherwise.

I hereby confirm, represent and warrant that I have never been convicted of a violent crime, child abuse or neglect, child pornography, child abduction, kidnapping, rape or sexual offense, nor have I ever been ordered by a court to receive psychiatric or psychological treatment in connection herewith.

I further irrevocably grant to Released Parties my consent and full right to use my name, photograph, likeness, image, voice and biography in any and all media, publications, advertising, and publicity, in connection with my participation hereunder.

This release shall inure to the Released Parties’ benefit. This release shall be governed by the laws of the State of Alabama.

Signature of Participant: Date: ______

(If Participant is a minor*, signature of Parent or Guardian)

*Per Alabama Code § 26-1-1:A minor is under the age of 19.

Please print clearly

Participant's Name:

Date of Birth:

Parent/Guardian (If Applicable):

Mailing Address:

City: State: Zip:

Home Phone: Email Address:______

Page 1 of 2