MINOR VOLUNTEER RELEASE FORM PLEASE READ THIS DOCUMENT CAREFULLY AND COMPLETELY BY SIGNING THIS AGREEMENT YOU WAIVE CERTAIN LEGAL RIGHTS by zjp17122

VIEWS: 0 PAGES: 2

Minor Volunteer Release Form document sample

More Info
									                           MINOR VOLUNTEER RELEASE FORM

                  PLEASE READ THIS DOCUMENT CAREFULLY AND COMPLETELY.
              BY SIGNING THIS AGREEMENT YOU WAIVE CERTAIN LEGAL RIGHTS.
          PARENTAL SIGNATURE REQUIRED FOR PARTICIPATION IN VOLUNTEER EVENT.


Name of Child: _____________________________________________                    Age____________

Name of Parent or Guardian: _____________________________________

Address of Parent or Guardian: ___________________________________ Apt.__________

City/State/Zip Code: ___________________________________________________________

Cell Phone: _____________________________________

Work Phone: ____________________________________

Home Phone: ____________________________________

E-mail Address: __________________________________



                             IN CASE OF AN EMERGENCY

Name of Contact Person: ____________________________________________________

Relationship: ______________________________________________________________

Phone Number of Contact Person (day): ___________________________________________

Phone Number of Contact Person (night): __________________________________________

I, ________________________________________ (Name of Parent or Guardian), the parent

and/or guardian of ____________________________________________ (Name of Participant)
(the “Child”), hereby consent to the Child being permitted to participate in a volunteer event
(hereafter, the “Volunteer Event”) sponsored by New York Restoration Project ("NYRP") and/or
MillionTreesNYC. As part of the Volunteer Event, the Child will help plant and care for trees at
various locations throughout New York City, including but not limited to: developments of the New
York City Housing Authority ("NYCHA"); schoolyards and playgrounds of the New York City
Department of Education (“DOE”); and streets, parks and playgrounds of the New York City
Department of Parks & Recreation (“Parks”).

I am fully aware, and hereby acknowledge, that work of the kind I have voluntarily agreed to allow
the Child to undertake involves inherent risks and dangers, including but not limited to: hazards of
travel by bus, automobile and/or other modes of transportation; forces of nature, illness or accidents
while participating in Volunteer Event or related activities: and damage to or loss of personal
property. Some of the work the Child may be invited to undertake may involve strenuous physical
activity, and with this knowledge, I hereby state that the Child is physically fit and prepared to
perform such work, and that the Child has no health-related conditions that will or ought to restrict
his or her participation in physical activities at the Volunteer Event. In case of an accident or medical
emergency, I authorize NYRP, NYCHA, DOE and/or Parks to secure proper treatment, hospitalize,
order injection, anesthesia or surgery for the Child, by a duly licensed medical doctor, clinic or
hospital.

In consideration of the Child's being permitted to participate in the Volunteer Event and in return for
the services provided by MillionTreesNYC, NYRP, NYCHA, DOE, Parks and/or their trustees,
directors, officers, employees, agents, associates, corporate sponsors, Members, successors and
assigns (collectively, the “Non-Profit and/or Public Parties”), I, the undersigned, hereby assume all
risks and responsibilities in any way associated with or inherent in the Child's participation in the
Volunteer Event, and, intending to be legally bound, hereby, for myself, my heirs, executors and
administrators, waive and release any and all rights and claims for damages the Child or I may have
against the Non-Profit and/or Public Parties, including for all injuries suffered by the Child or myself
as a result of said Volunteer Event, any liability that may arise because of the Child's participation in
the Volunteer Event, any liability arising from the Child's death, or from damage to personal property
or expenses in connection with the Volunteer Event, whether caused by the negligence of the Non-
Profit and/or Public Parties or otherwise, and whether or not such harms were reasonably
foreseeable. I also agree that neither the Child nor I will bring any legal actions against the Non-
Profit and/or Public Parties based upon the Child's participation in the Event.

I, the undersigned, voluntarily and without compensation grant permission to the Non-Profit and/or
Public Parties to take and use visual/audio images of the Child. Visual/audio images are any type of
recording, including photographs, digital images, drawings, renderings, voices, sounds, video
recordings, audio clips or accompanying written descriptions. I agree that the Non-Profit and/or
Public Parties own the images and all rights related to such images. The images may be used in
any matter or media without notifying me or the Child, including but not limited to use in web sites,
publications, promotions, broadcasts, advertisements, posters, presentations, exhibits and videos.

I further grant to the Non-Profit and/or Public Parties, without time restrictions, full rights to republish
or rebroadcast these images, and to use such images in official reports and for official business of
the Non-Profit and/or Public Parties. I waive any right to inspect or approve the finished images or
any printed or electronic matter that may be used with such images. I release the Non-Profit and/or
Public Parties, and any firm authorized to publish and/or distribute a finished product containing the
images, from any claims, damages or liability which I or the Child may ever have in connection with
the taking or use of the images or printed material used with the images.

I fully understand that the terms of this agreement shall bind me as well as the Child, my family
members, heirs, executors, administrators, and assigns. This agreement shall be governed by New
York law, and if any part of this agreement is held to be invalid or unenforceable, the validity and
enforceability of the remaining portions of this agreement shall be unaffected.


I HAVE READ THIS DOCUMENT CAREFULLY AND FULLY UNDERSTAND THAT THIS IS A RELEASE AND
                  WAIVER OF LEGAL RIGHTS AND AN ASSUMPTION OF RISK.



Signature of Parent/Guardian:                     ___________________

Name of Parent/Guardian (printed): ___________________

Date:                    __________________                                         ______

								
To top