Diaper Liability Form

Diaper Liability Form

ALL STATEMENTS MUST BE ANSWERED AND AGREED IN ORDER TO RECEIVE FROM THE HEALING HURTS DIAPER BANK TO PROTECT THE GIVING AND RECEIVING OF SERVICES EXTENDED BY OUR NONPROFIT
I waive, release, and discharge Healing Hurts Ministries from any and all liability, including but not limited to, liability arising from the use of diapers and/or infant wipe products of any kind received from this Diaper Bank.*

I AgreeI Do Not Agree
I will not hold Healing Hurts Ministries and/or their directors, officers, employees, volunteers, representatives, agents, and the activity holders, sponsors, and volunteers liable for any issues or complications with the diapers, wipes, clothing, or resources received, whether caused by the conditions or contents of received services.*

I AgreeI Do Not Agree
I acknowledge that Healing Hurts Ministries and their directors, officers, volunteers, representatives, and agents are NOT responsible for the errors, omissions, or conditions of any products received on their behalf.*

I AgreeI Do Not Agree
I acknowledge that the diapers and/or products have been provided to this agency by donations from partnering agencies community organizations, entities, and individuals. Any risks or issues incurred as a result of these items are not the fault of Healing Hurts Ministries.*

I AgreeI Do Not Agree
I understand that receiving these donations are only done by my request for assistance to fulfill a need for my household.*

I AgreeI Do Not Agree
I am aware that my demographic information will be used as data to capture statistical reporting and program outcomes.*

I AgreeI Do Not Agree
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