Partial Waiver and Release of Rights — Volunteer Insurance Coverage (VIC)
AUTHORIZED STATE VOLUNTEER PARTIAL WAIVER AND RELEASE OF RIGHTS UNDER THE OREGON TORT CLAIMS ACT ORS 30.260-300
As an authorized state volunteer performing activities on behalf of the State of Oregon and Oregon Parks and Recreation Department, I understand that the state will pay medical treatment bills, disability, death and dismemberment benefits to the limits and under the terms and conditions described in Oregon Department of Administrative Services Risk Management Division Policy Manual, Volunteer Injury Coverages, 125-7-204. In exchange for the coverage, I, for myself, my heirs, executors, administrators and assigns, release and forever discharge the State of Oregon from any and all demands or claims for damage or injury, from any cause of suit or action, known or unknown, that I may have against the State of Oregon, and/or its officers, agents or employees, and from all liability under the Oregon Tort Claims Act, ORS 30.260-300, for any and all harm or damage to my health in any manner resulting from or arising out of my state volunteer activities.
This release does not extend to or waive any rights I may have under the Oregon Tort Claims Act, ORS 30.260-300, to defense and indemnification from any demand, claim, suit or action brought against me, or liability I may be subject to, or arising out of my authorized state volunteer activities.
In the event that I am injured while performing state volunteer activities, I will notify my agency supervisor and apply for injury coverage benefits.