RELEASE AND WAIVER OF LIABILITY STATEMENT
Thank you for your application. By submitting this form, you are agreeing to be contacted to participate in the Training Wheels program. Please read and sign the Release and Waiver of Liability Statement below.
1. Waiver & Release – The Volunteer does hereby release and forever discharge and hold harmless Fort Bend Seniors Meals on Wheels and its successors and assigns from any and all liability, claims and demands of whatever kind or nature, either in lay or in equity, which arise or may hereafter arise from the Volunteer’s work for Fort Bend Seniors Meals on Wheels. The Volunteer understands and acknowledges that this Release discharges Fort Bend Seniors Meals on Wheels from any liability or claim that the Volunteer may have against Fort Bend Seniors Meals on Wheels with respect to any bodily injury, personal injury, illness, death or property damage that may result from the Volunteer’s work for Fort Bend Seniors Meals on Wheels.
2. Medical Treatment – Except as otherwise agreed to by Fort Bend Seniors Meals on Wheels in writing, the Volunteer does hereby release and forever discharge Fort Bend Seniors Meals on Wheels from any claim whatsoever that arises or may hereafter arise on account of any first aid, treatment or service rendered in connection with the Volunteer’s work for Fort Bend Seniors Meals on Wheels.
3. Assumption of the Risk – The Volunteer understand that the work for Fort Bend Seniors Meals on Wheels may include a variety of activities including, but not limited to: working in the Fort Bend Seniors Meals on Wheels office; food preparation; event set-up/clean-up; moving and transporting of business supplies and/or food stocks incidental to the operation of the agency; and the delivery of meals whether using the Volunteer’s personal vehicle or a vehicle owned by Fort Bend Seniors Meals on Wheels.
4. Photographic Release – The Volunteer does hereby grant and convey unto Fort Bend Seniors Meals on Wheels all right, title and interest in any and all photographic images, video or audio recordings made by Fort Bend Seniors Meals on Wheels during the Volunteer’s work for Fort Bend Seniors Meals on Wheels, including, but not limited to any royalties, proceeds or other benefits derived from such photographs or recordings.
5. Confidentiality – Please respect the confidentiality of all the information communicated to you or personally observed with regard to living conditions financial status or anything else of a personal/private nature. Please observe the 1996 HIPPAA guidelines and do not discuss clients’ health or anything else of a personal/private nature with anyone other than appropriate staff.
6. Solicitation/Gifts – Seniors are a vulnerable population and are due our utmost respect. Never solicit clients for business purposes/private gain, and do not accept gifts (unless it is a “token” gift, like a cookie, etc.). Therefore, the volunteer promises to hold in confidence and not divulge or use for business or personal gain any information regarding participants involved in Fort Bend Seniors Meals on Wheels (FBS). The volunteer will not violate the confidential relationship between FBS, its participants, programs, or volunteers. The volunteer accepts full responsibility for maintaining the confidential and private nature of all records and information entrusted to my care.
8. Other – The Volunteer expressly agrees that this Release is intended to be as broad and inclusive as permitted by the laws of the State of Texas, and that this Release shall be governed by and interpreted in accordance with the laws of the State of Texas. The Volunteer agrees that in the event that any clause or provision of this Release 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 be enforceable.