• GVI Wellness Program Casting Call

    Division of Personnel

  • As part of our ongoing commitment to supporting employees' health and wellness, we are seeking two employees or retirees willing to share their personal journeys managing diabetes or hypertension. We are seeking your assistance with a casting call.

    We know that living with these conditions can pose daily challenges, and that hearing from peers who have successfully navigated them can be a powerful source of encouragement and inspiration. We would like to feature two employees in a short wellness video to be highlighted during Diabetes Awareness Month and Hypertension Awareness Month.

    • Your experience living with diabetes or hypertension
    • Steps they have taken to manage their condition
    • Lifestyle changes, habits, or resources that have helped them improve their health
    • Words of encouragement for others who may be facing similar challenges

     

    Disclaimer and Consent

    By participating, you grant the Division of Personnel permission to use, reproduce, publish, distribute, and display any photographs, video recordings, audio recordings, testimonials, statements, or other content associated with your participation for official purposes.

    You understand and agree that the Division of Personnel may use such content in various formats and media, including but not limited to print publications, presentations, websites, social media platforms, newsletters, promotional materials, and other communications. The Division of Personnel reserves the right to use this content multiple times, in whole or in part, and in any manner deemed appropriate without additional notice, compensation, or approval.

  • Employment Status*
  • Date of Birth*
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  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • Participation Consent, Waiver, and Release of Liability

  • I. Voluntary Participation and Assumption of Risk

    I understand that participation in the Government of the Virgin Islands (GVI) Wellness Program activities organized by the Government of the Virgin Island's Division of Personnel's Group Health Insurance Unit is entirely voluntary and not a condition of employment.

    I acknowledge that GVI Wellness Program activities may include physical activity, exercise, wellness screenings, or other health-related activities. I understand that participation in such activities may involve certain risks, including but not limited to severe injury or harm. I knowingly and voluntarily assume full responsibility for all risks, known and unknown, directly and indirectly, associated with my participation in any GVI Wellness Program activity, including any resulting from my own action, inaction, or negligence.

    II. Medical Acknowledgment and Insurance

    I affirm that I am in good physical condition, able to participate, and have no known medical conditions, ailments, injuries or impainnents that would endanger myself or others through my participation. I understand that it is my responsibility to consult with a medical professional prior to engaging in any activity to determine fitness and capability. I agree to discontinue participation and notify staff if I experience any condition that would affect my ability to participate safely.

    If I am an insured Member as defined herein, any covered injury sustained during this activity may be eligible for benefits through Cigna up to the limits of my plan.

    Definition of Member: A "Member" is a full-time Government of the Virgin Islands (GVI) employee working at least 40 hours per week and paying group health insurance premiums, including their covered dependents (spouse or children, natural or adopted, under the age of 26) enrolled under the Cigna plan.

    III. Impairing Substance Acknowledgement

    I understand that the use of drugs, alcohol, or any impairing substance during any GVI Wellness Program is strictly prohibited. I agree that I will not be under the influence of any impairing substance while participating in the activity. Violation of this policy may result in immediate removal from the activity, disciplinary action, and forfeiture of eligibility to participate in future GVI Wellness Program activities.

    IV. Waiver, Release, and Indemnification

    In consideration for being allowed to participate, I agree to indemnify and hold harmless the Government of the Virgin Islands, its officers, agents, employees, contractors, sponsors, volunteers, or other representatives ("Released Parties") from any claims brought against them that results from my own action, inaction, omission, or violation of these terms. This indemnification does not apply to claims arising solely from the gross negligence or willful misconduct of the Released Parties. Nothing in this waiver shall affect or limit any rights I may have under applicable Workers' Compensation laws.

    V. Media Release and Ownership

    I grant full permission to the Government of the Virgin Islands to use photographs, video, audio, or any other media captured of my image, likeness, voice, or performance during my participation in any wellness activities. I understand that any such media, recordings, or materials shall be the sole and exclusive property of the GVI, and may be used, reproduced, published, or distributed in any manner it deems appropriate, without the need for further consent or compensation to me.

    VI. Severability

    If any provision of this waiver is held to be invalid or unenforceable, the remainder shall remain in full force and effect. The GVI reserves the right to modify any invalidated provision to the minimum extent necessary to preserve the intent of the parties.

    VII. Acknowledgment

    By signing below, I certify that I have read, understood, and voluntarily agree to the terms of this waiver and release and agree to abide by them.

  • Format: (000) 000-0000.
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