Waiver

Habitat for Humanity
Release and Waiver of Liability
Name of Homebuyer*
This Release and Waiver of Liability (the "Release"), executed on this
Date of Birth*

MonthDayYear
Date
Volunteer Full Legal Name (print)*
Nickname (if any)
Signature*

Clear
Date*

MonthDayYear
Date
Address*

Address

Street Address Line 2

City, State, ZipState / Province

Postal / Zip Code
(H)
(C)*
E mail*
example@example.com
Important Medical Information (if any)
Parent/Guardian Name if Minor Child is Volunteering
Signature of Parent/Guardian

Clear
Name of Parent/Guardian
Relationship to minor
(Home)
(Cell)
(Work)
IRHFH holds the right to refuse volunteers with certain criminal offenses. The information provided on this document will be checked against state and national sex offender registries and the IRC Sheriffs office. Individuals with unaccepted offenses will be asked to cease volunteer activities immediately.
Should be Empty:

Habitat for Humanity