October 20, 2009
Action Plan: Papering/Liability Release
Participant Liability Release Form
1 Timothy 6:18 “Command them to do good, to be rich in good deeds, and to be generous and willing to share them.”
Please read before signing, as this constitutes the agreement as a volunteer and the understanding of your working relationship as a volunteer with The United Methodist Church, New Hope Church, and Get In The Car.
I, ________________ acknowledge and state the following:
I have chosen to travel to perform clean-up/construction work designed to repair or replace homes.
I understand this work entails a risk of physical injury and often involves hard physical labor, heavy lifting and other strenuous activity; and that some activities may take place on ladders and building framing other than ground level. I certify that I am in good health and physically able to perform this type of work.
I understand that I am engaging in this project at my own risk. I understand that this is a “grass roots” activity to support individuals adversely affected by hurricane/flood disaster or are receiving assistance to repair or replace substandard housing. I assume all risk and responsibility for any damage or injury to my property any personal injury, which I may sustain while involved in this project, and related medical costs and expenses.
In the event that my supervising organization arranges accommodations, I understand they are not responsible or liable for my personal effects and property and that they will not provide lock up or security for any items. I will hold them harmless in the event of theft or loss resulting from any source or cause. I further understand that I am to abide by whatever rules and regulations may be in effect for the accommodations at that time.
By my signature, for myself, my estate and my heirs, I release, discharge, indemnify and forever hold The United Methodist Church, New Hope Church, and Get In The Car, together with their officers, agents, servants and employees, harmless from any and all causes of action arising from my participation in this project, and travel or lodging associated therewith, including any damages which may be caused by their negligence.
Print Name & Date:
Signature & Date:
Witness Signature & Date:
Official form may be found at www.getinthecar.org
Posted by jaselin at October 20, 2009 11:58 AM