Volunteer Release and Waiver of Liability
Rooster Haus Rescue
Today's date
*
-
Month
-
Day
Year
Date
Date of the first volunteer work party you plan to attend
*
-
Month
-
Day
Year
Date
Name
*
First Name
Last Name
Email address
*
example@example.com
Phone number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency contact name
*
First Name
Last Name
Emergency contact phone number
*
Please enter a valid phone number.
Format: (000) 000-0000.
How did you hear about Rooster Haus Rescue?
*
Why are you interested in volunteering at Rooster Haus Rescue?
*
Do you have any prior experience volunteering with animals, or any special skills we should know about (e.g. building or fixing things, familiarity with power tools, etc.)?
*
Have you had any contact with chickens, turkeys, ducks, geese, peafowl, quail, pheasants, or other farmed or wild birds in the last 30 days? Please explain.
*
This Release and Waiver of Liability executed on the above date by the above party ("Volunteer") releases Rooster Haus Rescue, a non-profit corporation organized and existing under the laws of the State of Washington, and each of its directors, officers, and agents. Volunteer desires to provide volunteer services for Rooster Haus Rescue and engage in activities related to serving as a volunteer. Volunteer understands that the scope of their relationship with Rooster Haus Rescue is limited to a volunteer position and that no compensation is expected in return for services provided by Volunteer; that Rooster Haus Rescue will not provide any benefits traditionally associated with employment to Volunteer; and that Volunteer is responsible for his/her own insurance coverage in the event of personal injury or illness as a result of Volunteer's services to Rooster Haus Rescue.
*
I agree
1. Waiver and Release: I release and forever discharge and hold harmless Rooster Haus Rescue and its successors and assigns from any and all liability, claims, and demands of any nature, either in law or in equity, which arise of may hereafter arise from the services that I provide to Rooster Haus Rescue. I understand and acknowledge that this Release discharges Rooster Haus Rescue from any liability or claim that I may have against Rooster Haus Rescue with respect to bodily injury, personal injury, illness, death, or property damage that may result from the services I provide to Rooster Haus Rescue or occurring while I am providing volunteer activities.
*
I agree
2. Insurance: I understand that Rooster Haus Rescue does not assume any responsibility for or obligation to provide me with financial or other assistance, including but not limited to medical, health, or disability benefits or insurance. I expressly waive any such claim for compensation or liability on the part of Rooster Haus Rescue beyond what may be offered freely by Rooster Haus Rescue in the event of injury or medical expenses incurred by me.
*
I agree
3. Medical Treatment: I hereby Release and forever discharge Rooster Haus Rescue from any claim whatsoever which arises or may hereafter arise on account of any first-aid treatment or other medical services rendered in connection with an emergency during my tenure as a volunteer with Rooster Haus Rescue.
*
I agree
4. Assumption of Risk: I understand that the services I provide to Rooster Haus Rescue may include activities that may be hazardous to me. As a volunteer, I hereby expressly assume risk of injury or harm from these activities and Release Rooster Haus Rescue from all liability.
*
I agree
5. Photographic Release: I grant and convey to Rooster Haus Rescue all right, title, and interests in any and all photographs, images, video, or audio recordings of me or my likeness or voice made by Rooster Haus Rescue in connection with my providing volunteer services to Rooster Haus Rescue.
*
I agree
6. Photography Use: For the safety of the residents, I agree that all photos taken by me must be approved by staff before being shared on any social media applications or other public forums.
*
I agree
7. Other: As a volunteer, I expressly agree that this Release is intended to be as broad and inclusive as permitted by the laws of the State of Washington and that this Release shall be governed by and interpreted in accordance with the laws of the State of Washington. I agree that in the event that any clause or provision of this Release is deemed invalid, the enforceability of the remaining provisions of this Release shall not be affected. By signing below, I express my understanding and intent to enter into this Release and Waiver of Liability willingly and voluntarily.
*
I agree
Signature
Submit
Should be Empty: