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NATIONAL VOLUNTEER FORM
Thursday, September 09, 2010
National Volunteer Form
Name
Date of Birth
Address
City
State*
Zip
Contact Number
Email*
Occupation
Languages Spoken
Spanish
French
Portuguese
English
Other Language
VOLUNTEER’S AGREEMENT AND RELEASE FROM LIABILITY
Voluntary Participation:
I acknowledge that I have voluntarily applied to participate in activities and/or events organized and/or sponsored by Prints Of Hope / Dejando Huellas. I understand that as a volunteer I will not be paid for my services. I further agree that my participation as a volunteer may be terminated at any time by Prints Of Hope / Dejando Huellas. I have no known physical or mental condition that would impair my capability to participate fully, as intended or expected of me.
Assumption of Risks:
I am aware that by participating as a volunteer, I may be exposed to personal injury, death, or damage to my property as a result of my activities, the activities of other volunteers, or the conditions under which my volunteer services are performed.
With knowledge of these risks, I agree to accept any and
all risks of personal injury, death, or damage to my property. I verify this statement by placing my initials here.
My initials.*
Include Parent/Guardian initials if a minor.
Release:
In consideration of the opportunity afforded me to participate as a volunteer, I hereby agree that I, my successors, assignees, heirs, guardians, and legal representatives, will not make any claim against Prints Of Hope / Dejando Huellas, its directors, officers, employees, volunteers, sponsors, local governments or any of its affiliated organizations, for injury, death, or damage resulting from the act or omissions of any person or entity, however caused, arising out of my participation as a volunteer. Without limiting the generality of the foregoing, I hereby waive and release my rights, actions or causes of action resulting from personal injury to me or my death, or damage to my property, sustained in connection with my volunteer participation. If I am less than 18 years of age, my legal parent or guardian waives and releases these rights on my behalf.
Media Release:
I further consent to the unrestricted use by Prints Of Hope / Dejando Huellas and/or any person authorized by them of any photographs, recordings, interviews, videotapes, motion pictures or similar visual or auditory recording of me created in connection with my volunteer participation.
Statement of Practice:
I understand and agree to abide by Scriptural principles to abstain from alcohol, drugs, tobacco and dress modestly while I am volunteering for any Prints Of Hope / Dejando Huellas projects in order to provide excellent service and present Jesus Christ as Lord.
Knowing and Voluntary Execution:
I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A CONTRACT AND A RELEASE OF LIABILITY BETWEEN MYSELF AND PRINTS OF HOPE / DEJANDO HUELLAS AND I SIGN IT OF MY OWN FREE WILL. BY SIGNING THIS AGREEMENT, I CERTIFY THAT I AM 18 YEARS OF AGE OR OLDER OR IF I AM UNDER 18 YEARS OF AGE, THAT I HAVE THE CONSENT, WAIVER AND AGREEMENT OF MY PARENT OR GUARDIAN AS EVIDENCED BY HIS/HER SIGNATURE BELOW TO PARTICIPATE PURSUANT TO THE ABOVE AGREEMENT, RELEASE AND WAIVER. I ALSO GIVE PERMISSION TO PRINTS OF HOPE / DEJANDO HUELLAS TO PERFORM A BACKGROUND CHECK ON ME. I verify this statement by placing my initials here.
My initials.*
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