Inspiritus Participant Liability Release Form
PLEASE READ BEFORE SIGNING
I, (participant name), acknowledge and state the following: I have chosen to travel and perform disaster clean up and recovery work.
I understand that 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 other than on 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 assume all risk and responsibility as well as related costs and expenses for any damage or injury to my property or any personal injury, which I may sustain while involved in this project.
I understand the need for confidentiality and will not discuss, photograph or otherwise disclose identifying information about the occupants of the house I am working in without prior permission from the volunteer coordinator and the family. This includes any reference to names, addresses, or other identifiable information.
By my signature, for myself, my estate, and my heirs, I release, discharge, indemnify and forever hold Inspiritus and Touchstone Youth Resource Services (hereinafter referred to as “Touchstone”), together with their officers, agents, servants, volunteers and employees, harmless from any and all causes of action arising from my participation in this project, including travel or lodging associated therewith, or any damages which may be caused by their own negligence.
COVID-19 Liability Waiver
I acknowledge the contagious nature of the Caronavirus/COVID-19 and that the CDC
And many other public health authorities still recommend practicing social distancing.
I further acknowledge that Inspiritus and Touchstone have put into place preventative measures to reduce the spread of Caronavirus/COVID-19.
I further acknowledge that Inspiritus cannot guarantee that I will not become infected with the Caronavirus/COVID-19. I understand that the risk of becoming exposed to and/or by the Caronavirus/COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Inspiritus and Touchstone staff, volunteers, and their families.
I am accepting service from Inspiritus and Touchstone and acknowledge that I am increasing my risk to exposure to the Caronavirus/COVID-19. I acknowledge that I must comply with all set procedures to reduce the spread of Caronavirus/COVID-19 while accepting assistance from Inspiritus and Touchstone.
I attest that:
I am not experiencing any symptoms of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell.
I have not traveled internationally within the last 14 days.
I have not traveled to highly impacted areas within the United States of America in the last 14 days.
I do not believe I have been exposed to someone with a suspected and/or confirmed case of Caronavirus/COVID-19.
I have not been diagnosed with Caronavirus/COVID-19 and not yet cleared as non-contagious by state or local public health authorities.
I am following all CDC recommended guidelines as much as possible and limiting my exposure to Caronavirus/COVID-19.
I hereby release and agree to hold Inspiritus and Touchstone harmless from, and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation relating to Caronavirus/COVID-19.
Please Answer the Following: