Volunteer Agreement for SS and LL

Volunteer Agreement

Ironwood Summer Staff and Leadership Live
Name

First NameLast Name
Cell Number
Format: (000) 000-0000.
E-mail
example@example.com
Date Arriving at Ironwood

MonthDayYear
Date
Expected Departure Date

MonthDayYear
Date
Which Team are you serving on this Summer?
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Church Name
Church City/State
Do you agree to follow the Summer Staff Manual?
Does Ironwood have your permission to check your references and background for any accusations or convictions related to child abuse, etc.?
Have you ever been charged with or convicted of any violent crimes or crimes against children?
Insurance Company
Policy Number
I have read and agree to the following:

Hold Harmless Agreement: I, the undersigned, agree that in the event any claim for personal injury, property damage, or wrongful death shall be prosecuted against Ironwood or its officers, agents, or employees, that I will indemnify and hold harmless Ironwood and its officers, agents, or employees from any and all claims or causes of action.

In Case of Emergency: I, the undersigned, hereby give permission to the physician selected by the Camp Director or his agent to hospitalize, secure proper treatment for, or order injection, x-ray, anesthesia, or surgery for the undersigned.

Termination: It is understood that either party may terminate this agreement at any time.

Insurance Coverage: I, the undersigned, understand that my personal insurance will provide primary coverage for medical aid and Ironwood will provide excess coverage.
Name
Signature
Date
Should be Empty: