Girl Talk Camp Volunteer Application & Waivers

Thank you for your interest in volunteering at Girl Talk Camp! We've planned an amazing week and can't wait to see you this summer! Before filling out the form below, please read the following tips:

1. To serve as a volunteer you will need to complete the form and all of the waivers below.  If you are under the age of 18, in addition to your signatures, your parents will also need to sign the waivers below. 

2. If you are 18+, Girl Talk requires you to pass a background check. Once we receive your application, we will send you a link to complete the background check.

3. If you have any questions, please contact Melissa Henriques at melissa@mygirltalk.org. 

I agree that each of the statements below are true:

1. My role is as a volunteer, and I will receive no financial reimbursement for services rendered.

2. I will complete the required training and orientation and will be aware of the assigned duties.

3. If I have any questions, I will seek guidance of a Girl Talk team member.

4. I recognize that any and all information shared with me as a part of my duties as a volunteer is confidential and shall not be divulged to unauthorized individuals, agencies, or ogranizations.

5. I will not copy, transcribe, record or memorize confidential information in any manner, nor disclose or use such information for any purpose other than for the limited purpose of providing the assigned volunteer assistance to Girl Talk.

6. I have never been convicted of a felony and have never been accused of any crime against children.

7. I understand that Girl Talk has the right, at any time, to suspend my ability to volunteer within the organization.

As a volunteer, you must read and sign all waivers below to serve at the Girl Talk Camp.

MEDICAL RELEASE

This is to certify that during the Girl Talk Camp held from June 6, 2022 - June 10, 2022, the parent or guardian of the minor listed within this form (“Youth”), or for myself, as an adult participant (collectively, “Participant”), give my consent to Girl Talk, Inc., staff for any of Girl Talk’s programs and/or activities, including without limitation to, The Girl Talk Camp, and Girl Talk’s medical representative to obtain medical care from any licensed physician, hospital, or clinic for the above mentioned Participant, for any injury that could arise from participation in the Girl Talk sponsored activity listed above. The  Participant herein described has permission to engage in all prescribed activities.

If I am a Youth, then in the event that the emergency contact provided above cannot be reached in an emergency, I hereby give permission to the physician selected by the Girl Talk representative to hospitalize, secure proper treatment for and to order injections, anesthesia, or surgery for my child as named above.

CONSENT AND RELEASE AGREEMENT

RELEASE OF AND WAIVER OF LIABILITY

As parent/guardian of _________________ (“Participant”), and as a condition of and as consideration for the willingness of Girl Talk, Inc. (“Organization”) to accept Participant as a participant in its Girl Talk Camp, and for other good and valuable consideration, the receipt and sufficiency of which are acknowledged, Participant does freely, voluntarily and without duress execute the following Release and Waiver of Liability (“Release”) for and on behalf of him or herself and his or her heirs, successors, beneficiaries and assigns:   

1. Release and Waiver of Liability. Participant releases, forever discharges, indemnifies, and holds harmless Organization and its directors, officers, employees, volunteers, agents, successors and assigns, and Holy Innocents Episcopal School, Inc. and its governing board, directors, officers, employees, volunteers, agents, successors and assigns (collectively the “Released Parties”) from any and all liability, claims, demands and causes of action of whatever kind or nature, either in law or in equity, arising out of or relating to Participant’s activities at Girl Talk Camp (“Activities”), including but not limited to any claim for any bodily injury, personal injury, illness, death or property damage that may arise out of, occur during or result from the Acctivities, regardless of whether caused in whole or in part by an act or omission of a Released Party. Participant also understands that, except as otherwise agreed to by a Released Party in writing, the Released Parties do not provide any financial assistance of any kind, including but not limited to medical, health or disability insurance coverage for any participant in Organization’s programs.   

PARTICIPANT UNDERSTANDS THAT THIS RELEASE DISCHARGES THE RELEASED PARTIES FROM ANY LIABILITY OR CLAIM THAT PARTICIPANT MAY HAVE AGAINST THE RELEASED PARTIES WITH RESPECT TO ANY BODILY INJURY, PERSONAL INJURY, ILLNESS, DEATH, PROPERTY DAMAGE, OR PROPERTY LOSS THAT MAY RESULT FROM THE ACTIVITIES, WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASED PARTIES OR OTHERWISE.

2. Medical Treatment. Participant releases, forever discharges, indemnifies, and holds harmless the Released Parties from any claim, demand or cause of action whatsoever arising out of or relating to any first aid or medical treatment rendered in connection with the Activities.

3. Assumption of the Risk. Participant understands that the Activities may involve activities that may be hazardous to the Participant and inherently dangerous risks, including but not limited to travel to and from Girl Talk Camp, using art supplies including scissors, playing outside on a playground, and performing movement exercises such as yoga and Zumba. Participant hereby expressly and specifically assumes the risk of damage, injury, harm or death in connection with such Activities.

a. COVID-19. In addition to any other risks posed by participating with the Organization, Participant understands that, despite any safety precautions being taken by the Organization, by participating in Activities with the Organization, there is a risk of potential exposure to COVID-19 or any other harmful virus or bacteria, which may result in illness or death. Participant releases, forever discharges, indemnifiesy, and holds harmless the Released Parties from any and all liability, claim, costs, or expense related to such risk.

4. Insurance. GIRL TALK INC. DOES NOT ASSUME ANY RESPONSIBILITY FOR OR OBLIGATION TO PROVIDE FINANCIAL ASSISTANCE OR OTHER ASSISTANCE OF ANY NATURE IN THE EVENT OF MY INJURY, ILLNESS, OR DEATH, OR DAMAGE TO OR LOSS OF MY PROPERTY.

5. Transportation Release. Participant releases, forever discharges, indemnified and holds harmless the Released Parties from any and all liability, loss, costs or expenses sustained or incurred because (a) Participant was injured, died or sustained property loss or damage while being transported by any of the Released Parties, or (b) because Participant injured another person or damaged the property of another person while being transported by any of the Released Parties. Participant releases, forever discharges, indemnifies and holds harmless the Released Parties from any and all liability, loss, costs or expenses sustained or incurred while being transported from the Activities if the Participant is released to a person with the assigned carpool number or, if requested, with a photo ID identifying them as a person listed above as permitted to pick the Participant up from Girl Talk Camp, in accordance with the process described above.

6. Photographs and other Media. Participant agrees to be photographed or recorded in other media, such as video or audio recordings, in connection with Activities or other activities or events of Girl Talk. Participant understands and agrees that the photographs and/or other media recordings may be used to promote Girl Talk, its services and events. Participant hereby irrevocably grants and conveys unto Girl Talk all right, title and interest in any and all photographic images and other media recordings taken during Activities or other activities and events of Girl Talk, including, but not limited to, any royalties, proceeds, or other benefits derived from such photographs or other media recordings. Participant understands and agrees that Participant is waiving all rights to privacy and ownership regarding the use of such photographs and other media recordings.

7. Miscellaneous. Participant expressly agrees that this Release is intended to be as broad and inclusive as permitted by the laws of the state of Georgia, and that this Release will be governed by and interpreted in accordance with the laws of the state of Georgia without giving effect to its conflict of laws rules. Participant agrees that in the event that any clause or provision of this Release is held to be invalid by any court of competent jurisdiction, the invalidity of that clause or provision will not affect the remaining provisions of this Release, which will continue to be enforceable. Participant agrees that the sole and exclusive  jurisdiction and venue for litigation between Participant and Organization will be a state or federal court having jurisdiction over Fulton County, Georgia.

BY SIGNING, I ACKNOWLEDGE THAT I HAVE READ AND UNDERSTOOD ALL OF THE TERMS OF THIS RELEASE AND THAT I AM VOLUNTARILY GIVING UP SUBSTANTIAL LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE THE RELEASED PARTIES.

 

Certification

I hereby certify that I (or my child, if  under 18) has not been convicted of a felony or any offense involving the physical or sexual abuse, molestation or rape of a child; and that I/she/he/they has not been convicted of a crime of moral turpitude (lying or stealing). I hereby certify that all information provided in this authorization is true, correct and complete and that I agree to abide by all rules, regulations and policies of the Girl Talk Camp. I understand that if any proves to be incorrect or incomplete that grounds for canceling any and all participation exists. I hereby agree, to the fullest extent permitted by applicable law, to indemnify and hold harmless discharge Girl Talk, Holy Innocents’ Episcopal School, its governing board, directors, officers, agents, consultants, employees, independent contractors and volunteers, and Girl Talk Camp, its owners, directors, officers, members, partners, staff, agents, consultants, employees, independent contractors and volunteers (collectively, the “Released Parties”), from, against and for any losses, costs, expenses, claims, demands, suits, judgments and all other liabilities (including attorney’s fees, expenses and court costs), to which the Released Parties may be subject as a result of any false statement contained in this Certification.

Confirmation

BY SUBMITTING THIS FORM, I UNDERSTAND I AM DELIVERING ELECTRONIC SIGNATURES THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

 

Please note, you are not registered as a volunteer until this form, all waivers and background check (if applicable) are successfully completed and submitted.