LeadUS Mentoring Program 2015-16

Partner with an amazing network of empowered Compton residents today!

Bright Lights Of Compton (BLOC) requests that partners observe this agreement/pledge for our events:
- I live, work, or serve in the city of Compton
- I will maintain & improve my home and neighborhood
- I will encourage neighbors to join me as Bright Lights
To participate, please indicate your agreement below and select Next*

I agree
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Name*

FirstLast
Email*
Mobile Number*
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By clicking the "Submit" button, you agree that you have provided only truthful information on this form and you understand that we will only use your information for purposes of The Compton Initiative & Bright Lights Of Compton.*

Yes, I understand and agree.
AGE VERIFICATION AND WAIVER SIGNATURE
Are you under the age of 18?*
THE COMPTON INITIATIVE

BRIGHT LIGHTS OF COMPTON
VOLUNTEER/PARTNER RELEASE OF LIABILITY
AND PERMISSION TO BE PHOTOGRAPHED/TAPED

I agree to be a volunteer/partner for The Compton Initiative during its Bright Lights Of Compton program.
The Bright Lights Of Compton program gathers church members and other interested participants who wish to volunteer/partner in cleaning up and beautifying areas around the Compton community. Volunteers/partners may be asked to pick up and bag litter and trash, do light gardening work, sweep streets and walkways, paint buildings, and other similar activities.
I understand that my participation in the Bright Lights Of Compton program is purely voluntary, without any expectation of payment or remuneration of any type, and I will not be covered under The Compton Initiative’s or Emmanuel Reformed Church's ("ERC") workers’ compensation insurance policy.
By signing this Volunteer/Partner Release of Liability, I am certifying that I am medically fit to perform the types of physical activities associated with the Clean-Up Day program. If there is any question regarding my medical fitness, I agree to seek medical consultation before I volunteer.
I hereby fully release and discharge The Compton Initiative and ERC, their respective employees, property owners and other volunteers/partners from any injuries or losses I suffer that are related in any way to my volunteering for the Bright Lights Of Compton program.
I fully understand this is a RELEASE OF LIABILITY and that I am giving up my right to sue The Compton Initiative or ERC, their respective employees, property owners and other volunteers/partners for any injury or losses suffered as a result of my volunteering for the Bright Lights Of Compton Program.
I also give full permission for representatives of ERC or The Compton Initiative in Paramount, California to capture video, audio, still images or any other personal identification characteristics of me to be used in any manner, throughout the universe, in perpetuity, in any and all media, now known or hereafter devised, including the right to edit, delete, dub and/or fictionalize such materials. I waive any and all rights to compensation and ownership of such materials or to restrict usage of such materials.

By signing below, you certify that you have read The Compton Initiative’s Waiver of Liability Form and fully understand and agree to its terms.
THE COMPTON INITIATIVE

BRIGHT LIGHTS OF COMPTON
PARENTAL CONSENT, RELEASE OF LIABILITY
AND PERMISSION TO BE PHOTOGRAPHED/TAPED

I agree to allow my child to volunteer for The Compton Initiative’s Bright Lights Of Compton program.
I understand that my child’s participation in the Bright Lights Of Compton program is purely voluntary, without any expectation of payment or remuneration of any type, and he or she will not be covered under The Compton Initiative’s or Emmanuel Reform Church's ("ERC") workers’ compensation insurance policy.
I hereby certify that my child is medically fit to perform the types of physical activities associated with the Bright Lights Of Compton program. If there is any question regarding my child’s medical fitness, I agree to seek a medical consultation before he or she participates in the Bright Lights Of Compton program.
I hereby fully release and discharge The Compton Initiative, ERC, and ACP, their respective employees, property owners and other volunteers/partners from any injuries or losses my child may suffer that are related in any way to his or her volunteering for the Bright Lights Of Compton program.
I fully understand this document, and I am aware that this is a release of liability and that I am giving up my right to sue The Compton Initiative or ERC, their respective employees, property owners or other volunteers/partners for any injury or loss suffered by my child as a result of his or her participation in the Clean-Up Day program.
I also give full permission for representatives of, The Compton Initiative and/or ERC in Paramount, California to capture video, audio, still images or any other personal identification characteristics of my child to be used in any manner, throughout the universe, in perpetuity, in any and all media, now known or hereafter devised, including the right to edit, delete, dub and/or fictionalize such materials. I waive any and all rights to compensation and ownership of such materials or to restrict usage of such materials.
Name of Parent/Guardian

First NameLast Name
By signing below, you certify that you have read The Parental Consent and Release of Liability Form and fully understand and agree to its terms.
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