LeadUS Mentoring Program 2015-16

Are you ready to Just Do Good on April 18th?

The Compton Initiative requests volunteers observe these requirements for our Clean-Up Day events:
- I will be friendly and respectful
- I am able to arrive by 7:30 am
- I am able to do painting, cleaning and gardening projects
- I am 18 or older (or will be accompanied by a responsible adult)
I agree
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Full Name*

FirstLast
Email*
Mobile Number*

Area CodePhone Number
Are you a part of an organization or group already registered with The Compton Initiative?*
Please complete the following ONLY IF you are a Group Leader

I need to register a new organization or group
Select the name of your organziation*
Enter the name of your organization:*
Please allow up to 7 days for your group registration to be processed.
How many volunteers in your group?*
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AGE VERIFICATION AND WAIVER SIGNATURE
Are you under the age of 18?*
THE COMPTON INITIATIVE

CLEAN-UP DAY
VOLUNTEER RELEASE OF LIABILITY
AND PERMISSION TO BE PHOTOGRAPHED/TAPED

I agree to be a volunteer for The Compton Initiative during its Clean-Up Day program.
The Clean-Up Day program gathers church members and other interested participants who wish to volunteer in cleaning up and beautifying areas around the Compton community. Volunteers 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 Clean-Up Day 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 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 from any injuries or losses I suffer that are related in any way to my volunteering for the Clean-Up Day 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 for any injury or losses suffered as a result of my volunteering for the Clean-Up Day 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

CLEAN-UP DAY
PARENTAL CONSENT, RELEASE OF LIABILITY
AND PERMISSION TO BE PHOTOGRAPHED/TAPED

I agree to allow my child to volunteer for The Compton Initiative’s Clean-Up Day program.
I understand that my child’s participation in the Clean-Up Day 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 Clean-Up Day program. If there is any question regarding my child’s medical fitness, I agree to seek a medical consultation before I he or she participates in the Clean-Up Day program.
I hereby fully release and discharge The Compton Initiative, ERC, and ACP, their respective employees, property owners and other volunteers from any injuries or losses my child may suffer that are related in any way to his or her volunteering for the Clean-Up Day 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 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.
Today's Date*

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Signature*

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