Day of Caring - Waiver | United Way of Central West Virginia

Volunteer Information

Name

Company

Phone

Address

City

State

Zip Code

Waiver

WAIVER & RELEASE: The Volunteer desires to work as a volunteer for United Way and is aware of the wide range of activities associated with volunteering for Day of Caring and has made a voluntary choice to engage in these activities. The Volunteer does hereby freely, voluntarily and without duress agree to this statement

I agree with the Waiver and Release Statement

MEDICAL TREATMENT: In consideration of being permitted  to participate in Day of Caring, Volunteer agrees to release and forever discharge and hold harmless the United Way, its successors and assigns, collectively or individually, 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 work as part of Day of Caring. This includes all work being undertaken at any project site including but not limited to, United Way member agencies, other non-profit organizations, residents who are having work undertaken at their private homes, and any other party having a legal interest in the property on which Day of Caring projects/events take place. Volunteer acknowledges that this Release forever discharges United Way from any and all liability, claim or cause of action that the Volunteer may have against United Way with respect to any bodily injury, personal injury, illness, loss, death or damage to personal property that may result directly or indirectly from Volunteer’s work relating to Day of Caring. Volunteer also acknowledges that United Way does not assume any responsibility for or obligation to provide financial assistance or any other assistance, including but not limited to medical, health or disability insurance in the event of injury or illness to the Volunteer arising from Day of Caring. 

I agree with the Medical Treatment Statement

ASSUMPTION OF RISK: Except as otherwise agreed to by United Way in writing, Volunteer does hereby release and forever discharge United Way from any claim whatsoever which arises or may hereafter arise on account of any first aid, treatment, medical care or service rendered in connection with the Volunteer’s work relating to the Day of Caring. The Volunteer acknowledges that the work undertaken as part of the Day of Action may include activities that may be hazardous to the Volunteer.  Volunteer hereby expressly and specifically assumes the risk of injury or harm in these activities and releases United Way from any and all liability for injury, illness, death or property damage resulting from the Volunteer’s activities relating to the Day of Action. 

I agree with the Assumption of Risk Statement

INSURANCE: The Volunteer acknowledges that United Way does not carry or maintain health, medical or disability insurance coverage for any volunteer.  EACH VOLUNTEER IS ENCOURAGED TO OBTAIN HIS OR HER OWN MEDICAL AND/OR HEALTH INSURANCE COVERAGE.

I agree with the Insurance Statement

PHOTOGRAPHY RELEASE: Volunteer agrees to and permits United Way to take photographic images and video and audio recordings of him/her during his/her work relating to the Day of Caring. Volunteer also grants and conveys to United Way all rights, titles and interests in said photographic images and video and audio recordings, including but not limited to, any royalties, proceeds or other benefits derived from such photographs or recordings.  Volunteer further consents to and authorizes United Way to use and reproduce said photographic images, video and audio recordings and to circulate and publicize the same by all means, including but not limited to, newspapers and other print media, television media, brochures, pamphlets, marketing materials and websites.  

I agree with the Photography Release Statement

Signature Date

Volunteer Signature