Utah CycleNation

All minors under the age of 18 will need the below waiver and minor medical release signed by a parent or legal guardian. Volunteers 15 and under must have both forms and a parent/guardian with them during their volunteer shift.

VOLUNTEER CONSENT, RELEASE AND INDEMNIFICATION

1. CONSENT. I acknowledge that I am volunteering for the American Heart Association, Inc. (“AHA”) as a volunteer with the American Heart Association. I agree that I will not be paid for my services and will not be covered by AHA’s insurance. I further agree that my volunteering may be terminated at any time by the AHA or by me.

2. ASSUMPTION OF RISK. Volunteering in the Event involves potentially hazardous activities that may include risks such as, but not limited to, falls, contact with participants and effects of weather. In consideration of being allowed to volunteer, I hereby expressly assume all risks, including personal injury and death arising out of my volunteering. I am solely responsible for my own health and safety and represent that I am physically fit and able to volunteer for the AHA. I further agree that I will not operate any automobile for any purpose related to my volunteering.

3. RELEASE AND INDEMNIFICATION. I agree, for myself, my heirs, executors and administrators, to not sue and to release, indemnify and hold harmless, the American Heart Association, Inc., its affiliates, officers, directors, volunteers and employees, and all sponsoring businesses and organizations and their agents and employees (collectively “AHA Parties”), from any and all liability, claims, demands and causes of action whatsoever, arising directly or indirectly out of my volunteering for the Event — whether it results from the negligence of the AHA Parties or from any other cause.

4. PHOTOGRAPH AND RECORDING AUTHORIZATION. I authorize the use, copyright, or publication of my name, image, or voice from volunteering in the Event as may be captured by photograph or recording in any medium (“recordings”) for promotional purposes related to AHA’s mission and this Event, including illustration, promotion, or advertisement. As a condition of volunteering, I grant AHA a perpetual, irrevocable, worldwide, transferable, royalty- free, and non-exclusive license to use, reproduce, adapt, modify, publish, distribute, publicly perform, and create a derivative work from the recordings, including display on the AHA website, without any attribution or compensation, with the goal to promote and support the AHA mission. Examples of promotion and mission related activities include, but are not limited to social media, media relations, consumer relations, donor relations, and storytelling.

This agreement is meant to be as broad and inclusive as permitted by the State in which the Event is conducted.

If any portion of it is invalid, the balance will continue in full force and effect.

 

BY SIGNING, I ADMIT THAT I HAVE READ AND UNDERSTOOD ALL THE TERMS OF THIS CONSENT, RELEASE AND INDEMNIFICATION, AND THAT I AM GIVING UP SUBSTANTIAL LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE THE AHA.

I have read, understood, and agreed to the terms of this agreement.

 

FOR ANY VOLUNTEER UNDER THE AGE OF 18, A PARENT OR GUARDIAN MUST AGREE TO THE BELOW:

I am the legal guardian of the Volunteer, and I hereby consent to his/her volunteering. I have read the foregoing Consent, Release and Indemnification and I hereby agree on behalf of myself and Volunteer to its terms.

 

EMERGENCY MEDICAL TREATMENT AUTHORIZATION FOR MINOR

I represent to the American Heart Association, Inc.  (‘AHA”) that I am the parent or legal guardian of the minor Volunteer.  In case of a medical or dental emergency, I request that I be contacted at the telephone number below. 

 

I hereby authorize the AHA and staff to order emergency medical treatment for the minor as he or she deems necessary while minor is volunteering.  Notwithstanding the foregoing, I acknowledge that the AHA is under no obligation to contact any medical professional or hospital to render medical assistance to the minor.