Parent REACH & COVID-19 Liability Release Waiver

REACH Volunteer Waiver

and COVID-19 Liability Release Waiver
Name of person completing this form

First NameLast Name
Volunteer Name*

First NameLast Name
I am completing this for my child who is under the age of 18*

YesNo, I am completing this for myself and I'm over the age of 18
General Volunteer Waiver

Please read and acknowledge consent by checking each box.
I, {volunteerName}, desire to work as a volunteer for REACH, Inc (Reading Enriches All Children) and engage in activities related to being a volunteer for a work project.
I, the Volunteer, release and hold harmless REACH, Inc and their partners, its successors and assigns from any and all liability, claims, and demands of whatever kind or nature, either in law or in equity, which arise or may hereafter arise from my volunteer work with the REACH, Inc.By submitting this application to volunteer with REACH, I do hereby certify that I have never beenconvicted of a felony offense or any offense involving the sexual molestation or physical or sexual abuse of a child. I alsoexpressly agree to notify REACH within 24 hours of an arrest for any such criminal offense. I alsounderstand that I will be required to check in with a REACH employee each time Ivolunteer.I understand that this waiver discharges REACH from any liability or claim that I, the Volunteer, may have against REACH and their partners with respect to bodily injury, personal injury, illness, death, or property damage that may result from my participation on REACH's work site. I also fully understand that the REACH does not assume any responsibility for or obligation to provide financial assistance or other assistance, including but not limited to medical, health or disability insurance, in the event of injury, illness, death or property damage.I, the Volunteer, understand that I expressly waive any such claim for compensation or liability on the part of REACH beyond what maybe offered freely by the representative of REACH in the event of such injury or medical expense.I hereby release REACH from any claim whatsoever which arises or may arise in the future on account of any first aid treatment or other medical services that are conducted in connection with an emergency during my time with REACH.I understand that my time with REACH may include various activities that may be hazardous to me and I hereby expressly and specifically assume the risk of injury or harm in these activities and release REACH from all liability for injury, illness, death, or property damage resulting from the activities of my time with REACH.I expressly agree that this waiver is intended to be as broad and inclusive as permitted by the laws of the State of Virginia in the United States of America, and that this waiver shall be governed by and interpreted in accordance with the laws of the State of Virginia. I agree that in the event that any clause or provision of this waiver shall be held to be invalid by any court of competent jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining provisions of this Release which shall continue to enforceable.
Emergency Contact Information

Please share one emergency contact in case of an emergency
Name of Emergency Contact*
Relationship to Emergency Contact*
Phone number of Emergency Contact*

Area CodePhone Number
COVI-19 waiver

The World Health Organization has declared the novel Coronavirus (COVID-19) a worldwide pandemic. Due to its capacity to transmit from person-to-person through respiratory droplets, the government has set recommendations, guidelines, and some prohibitions which REACH, Inc. (the "Organization") adheres to comply.
In consideration of my participation in the foregoing, the undersigned acknowledge and agree to the following:*

I am aware of the existence of the risk on my physical appearance to the venue and my participation to the activity of the Organization that may cause injury or illness such as, but not limited to Influenza, MRSA, or COVID-19 that may lead to paralysis or death.I have not experienced symptoms that of fever, fatigue, difficulty in breathing, or dry cough or exhibiting any other symptoms relating to COVID-19 or any communicable disease within the last 14 days.I have not, nor any member(s) of my household, traveled by sea or by air, internationally within the past 30 days.I did not, nor any member of my household, visit any any area within the United States that was reported to be highly affected by COVID-19, in the last 30 days .I have not been, nor any member(s) of my household, diagnosed to be infected of COVID-19 virus within the last 30 days.
Following the pronouncements above I hereby declare the following:*

I am fully and personally responsible for my own safety and actions while and during may participation and I recognize that I may be in any case be at risk of contracting COVID-19.With full knowledge of the risks involved, I hereby release, waive, discharge the Organization, its board, officers, independent contractors, affiliates, employees, representatives, successors, and assigns from any and all liabilities, claims, demands, actions, and causes of action whatsoever, directly or indirectly arising out of or related to any loss, damage, injury, or death, that may be sustained by me related to COVID-19 while participating in any activity while in, on, or around the premises or while using the facilities that may lead to unintentional exposure or harm due to COVID-19.I agree to indemnify, defend, and hold harmless the Organization from and against any and all costs, expenses, damages, lawsuits, and/or liabilities or claims arising whether directly or indirectly from or related to any and all claims made by or against any of the released party due to injury, loss, or death from or related to COVID-19.I affirm that this waiver, in its entirety, includes any and all liability or claim that I, the volunteer may have against the organization, with respect to any exposure I may have to COVID-19 as a volunteer.
By signing below I acknowledge that I have read the foregoing Liability Release Waiver and understand its contents; that I am at least eighteen (18) years old and fully competent to give my consent; That I have been sufficiently informed of the risks involved and give my voluntary consent in signing it as my own free act and deed; that I give my voluntary consent in signing this Liability Release Waiver as my own free act and deed with full intention to be bound by the same, and free from any inducement or representation.

This waiver will remain effective until laws and mandates relevant to COVID-19 are lifted.
Phone Number*

Area CodePhone Number
Email*
example@example.com
Date Signed*

MonthDayYear
Date
Signature*

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Should be Empty:

REACH Volunteer Waiver

General Volunteer Waiver

Emergency Contact Information

COVI-19 waiver