Girls Giving Grants (g3) Conflict of Interest and Parental/Guardian Permissions

1. Media Release

2. Waiver and Release of General Liability

3. Waiver and Release of COVID-19 Liability

4. Conflict of Interest Policy and Agreement

 

Please provide all the information requested below and sign each form as appropriate.

MEDIA RELEASE

This Media Release Form (“Release”) is to be used by Impact Austin and/or Girls Giving Grants (“Organization”) for the purpose of participating in community and media relations for an indefinite period of time, unless otherwise specified. A Release should be executed for each member of the Organization.

IF PERSON BEING USED IN THE MATERIAL IS UNDER I8 YEARS OF AGE, PARENT OR LEGAL GUARDIAN MUST SIGN THIS FORM.

I understand that as a member of the Organization, that I (we) may be photographed and/or videotaped. I agree, without any further right to compensation, to allow my / my child’s name, biographical information, photo/video, voice or likeness (“Media”) to be used for any legitimate purpose by the Organization, or their successors, assigns, and/or designees and grant them the worldwide rights in perpetuity, in all forms and media whatsoever, including, without limitation, Internet, multimedia, print, billboards, radio, television, motion pictures, videocassettes, DVDs, CDs and other electronic media, in and to my / my child’s name, biographical information, likeness, photograph, voice and appearance. The Organization is and will remain the owner of the Media and all copyrights, trademarks, and other rights relating thereto that I may hold are hereby assigned to the Organization. I agree that I / my child shall not have any right of approval, claim to compensation, and no claim (including, without limitation, claims based upon invasion of privacy, defamation, or right of publicity) arising out of any use, alteration, blurring, distortion, faulty reproduction, illusionary effect, or use in any composite form of my or my child’s name, photo/video, voice, likeness or appearance.

This release shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. If any provision of this Release is held invalid under any applicable law, such invalidity will not affect any other provision that can be given full effect without the invalid provision. This Release shall be governed and construed pursuant to the laws of the State of Texas without reference to its conflict of laws rules.

I HAVE CAREFULLY READ THIS RELEASE. I UNDERSTAND THAT IT IS A COMPLETE RELEASE OF LIABILITY. I WARRANT THAT I AM AT LEAST 18 YEARS OF AGE AND HAVE THE RIGHT TO AUTHORIZE AND SIGN THIS RELEASE ON BEHALF OF MYSELF OR MY CHILD.

Girls Giving Grants (g3) Waiver and Release of Liability

In consideration of the opportunity to participate in Girls Giving Grants (g3) for the upcoming school year with meetings held at the Big Brothers Big Sisters of Central Texas, and to attend the Site Visits sponsored by Girls Giving Grants at the locations of the chosen nonprofit organizations, the undersigned g3 member and the undersigned parent or legal guardian if the g3 member is under age 18, waive(s), release(s) and agree(s) to hold harmless Girls Giving Grants and Impact Austin, and their respective agents, officers, board members, representatives, employees and volunteers (the “Releasees”) from any liability to the undersigned and the personal representatives, heirs, assigns, and family of the undersigned, for all loss or damages on account of injury to the person or property of the undersigned g3 member relating to attendance at the event or transportation to or from the event, whether caused by the negligence, gross negligence or recklessness of the Releasees or otherwise. The undersigned have read the Waiver and Release of Liability and voluntarily sign. 

Required signature of the member or parental/guardian, if the member is under 18 years of age.

Consent/Waiver and Release of Liability

I give my permission for my g3 member or myself (if over 18 years of age) to participate in the events as described above, and I further agree to all the terms of the Waiver and Release of Liability stated herein.

Girls Giving Grants (g3) Waiver and Release of Coronavirus/COVID-19Liability

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is reported to be extremely contagious. The state of medical knowledge continues to evolve, but the virus is believed to spread from person-to-person contact and/or by contact with contaminated surfaces and objects, and even possibly in the air. People reportedly can be infected and show no symptoms and therefore spread the disease. There is no known cure for COVID-19, but there are evolving vaccines and treatments.

Impact Austin/G3 cannot prevent you from becoming exposed to, contracting, or spreading COVID-19 while attending in-person meeting(s) and/or event(s) sponsored by Impact Austin/G3 to be held on third-party premises.  It is not possible to prevent against the presence of the disease. Therefore, if you choose to attend any in-person meeting(s) and/or event(s) sponsored by Impact Austin/G3 that may be held at or on third-party premises, you may be exposing yourself to and/or increasing your risk of contracting or spreading COVID-19.

ASSUMPTION OF RISK: I have read and understood the above warning concerning COVID-19. I hereby choose to accept the risk of contracting COVID-19 for myself in order to attend in-person meetings(s) and/or event(s) sponsored by Impact Austin/G3 held on third-party premises. These in-person meeting(s) and/or event(s) are of such value to me that I accept the risk of being exposed to, contracting, and/or spreading COVID-19 in order to attend Impact Austin/G3’s meeting(s) and/or event(s) in person. 

WAIVER OF LAWSUIT/LIABILITY: I hereby forever release and waive my right to bring suit against Impact Austin/G3 and its members, officers, directors, managers, officials, agents, employees, or other representatives in connection with exposure, infection, and/or spread of COVID-19 related to my attendance at in-person meeting(s) and/or event(s) held on third-party premises. I understand that this waiver means I give up my right to bring any claims including for personal injuries, death, disease or property losses, or any other loss, including but not limited to claims of negligence and give up any claim I may have to seek damages, whether known or unknown, foreseen, or unforeseen.

CHOICE OF LAW: I understand and agree that the law of the State of Texas will apply to this agreement.

Consent/Waiver and Release of Coronavirus/COVID-19 Liability

I HAVE CAREFULLY READ AND FULLY UNDERSTAND ALL PROVISIONS OF THIS RELEASE, AND FREELY AND KNOWINGLY ASSUME THE RISK AND WAIVE MY RIGHTS CONCERNING LIABILITY AS DESCRIBED ABOVE:

I am the parent or legal guardian of the minor named above (or myself if over 18).  I have the legal right to consent to and, by signing below, I hereby do consent to the terms and conditions of this Release.

GIRLS GIVING GRANTS (g3)

CONFLICT OF INTEREST POLICY AND AGREEMENT

 1. Purpose

The purpose of this Conflict of Interest Policy is to assist the Co-Chair(s) of Girls Giving Grants (g3), the Advisors and Members of Girls Giving Grants (collectively, “Members”) in identifying and avoiding situations that present potential conflicts of interest. Girls Giving Grants is committed to avoiding potential conflicts of interest in order (1) to protect the integrity of Girls Giving Grants’ decision-making process, (2) to ensure that our Grant Applicants and the nonprofit community as a whole, have confidence in our integrity, and (3) to protect the integrity and reputations of all Members of Girls Giving Grants. This Conflict of Interest policy also provides Girls Giving Grants with a procedure that permits a Grant Applicant to be considered for Girls Giving Grants’ grant award even though one or more Members may have a conflict of interest with respect to the Grant Applicant.

2. Standard of Behavior

A Member of Girls Giving Grants may not use her position with Girls Giving Grants to achieve a personal benefit for herself, whether financial or non-financial, directly or indirectly. Girls Giving Grants’ Members must scrupulously avoid conflicts of interest between the interests of Girls Giving Grants and personal, scholastic, extra-curricular, professional and business interests. This includes avoiding potential and actual conflicts of interest, as well as taking affirmative action to avoid perceptions of conflicts of interest. This policy is intended to supplement but not replace any applicable laws governing conflicts of interest in nonprofit and charitable organizations.

3. Conflict of Interest Defined

A conflict of interest may arise if a Member has a personal, organizational or professional interest that is in conflict with the best interest of Girls Giving Grants. A Member is usually considered to have a conflict of interest if she or a Family Member:

a. Has a substantial financial interest in any Grant Applicant or in any organization having a substantial financial interest in any Grant Applicant. A “substantial financial interest” in an entity is a financial interest of any kind, which, in view of all the circumstances, is substantial enough that it would, or reasonably could, affect the judgment of the Member or her Family Member.

b. Holds a position (whether paid or unpaid) as a trustee, director, general manager, Board Member, partner, principal officer, representative, consultant or employee of any Grant Applicant.

c. Holds a position (whether paid or unpaid) as a trustee, director, general manager, Board Member, partner, principal officer, representative, consultant or employee of any organization that performs functions similar to Girls Giving Grants.

d. Uses “inside information” for personal benefit, benefit to any Grant Applicant, or to the detriment of Girls Giving Grants. “Inside information” is information that has not been made public and was obtained through the Member’s work or position with Girls Giving Grants.

e. Uses her position with Girls Giving Grants for a personal, professional or organizational benefit that is in conflict with the best interest of Girls Giving Grants.

f. Accepts gifts, entertainment or other favors from any Grant Applicant or potential Grant Applicant or from any charitable organization operating in Travis, Williamson, Bastrop or Hays counties, Texas, under circumstances where it might be inferred that such action was intended to influence or possibly would influence the Member in the performance of her duties on behalf of Girls Giving Grants.

g. Has or promotes an interest which results in, or may be reasonably perceived to result in, an interference with the objectivity with which the Member is expected to exercise her duties on behalf of Girls Giving Grants.

4. Definitions

a. “Co-Chair(s) of Girls Giving Grants” is any Member of the Board of Directors of Impact Austin that serves as the managing liaison between Girls Giving Grants and Impact Austin.

b. “Member” is any Member of Girls Giving Grants.

c. “Advisor” is any individual selected by the Co-Chair(s) of Girls Giving Grants to advise Girls Giving Grants youth members.

d. “Family Member” is a parent, step-parent, brother, step-brother, sister, step-sister, spouse of a brother or sister, or in-law, grandparent, step-grandparent, of a Member.

e. “Grant Applicant” is a person or organization that has received, is receiving or is seeking to receive a grant or other financial commitments from Girls Giving Grants.

5. Duty to Disclose

a. Prior to attending the Application Review Committee (“ARC”) meeting, each Member is required to review a copy of this Conflicts of Interest Policy and to acknowledge in writing that she has done so by signing below.

b. Prior to attending the ARC meeting, each Member is also required to complete a Conflict of Interest Disclosure Form (attached) identifying any relationships, positions or circumstances that the Member believes could contribute to a conflict of interest arising, including but not limited to any affiliation with any Grant Applicant. Such Conflict of Interest Disclosure Form shall be updated annually.

c. Any information disclosed on the Member’s Conflict of Interest Disclosure Form shall be treated as confidential and shall generally be made available only to Co-Chair of Girls Giving Grants, Advisors and ARC Chairs, except to the extent additional disclosure is necessary in connection with the implementation of this policy. 

d. The Members shall review this policy annually. Any changes to the policy shall be communicated immediately to all Members of Girls Giving Grants. 

6. Procedures Where a Conflict of Interest is Present

A Grant Applicant may still be considered for Girls Giving Grants’ grant notwithstanding the existence of a conflict of interest, provided that the following procedures are strictly adhered to:

a. Prior to any action by the ARC, a Member who has a conflict of interest and who is in attendance at the meeting shall disclose all facts material to the conflict of interest. Such disclosure shall be reflected in the minutes of the meeting. 

b. A Member who does not plan to attend a meeting at which she has reason to believe that the ARC will act on a matter in which the person has a conflict of interest shall disclose to the Advisor of the meeting all facts material to the conflict of interest. The Advisor shall report the disclosure at the meeting and the disclosure shall be reflected in the minutes of the meeting. If the Member having the conflict of interest is the Advisor, then the required disclosure shall be made to, and the required report be made by, the secretary.

c. A Member who has a conflict of interest shall not participate in the discussion of the matter except to disclose material facts and to respond to questions. Such person shall not attempt to exert her personal influence with respect to the matter, either at or outside the meeting.

d. If it is not entirely clear whether or not a conflict of interest exists, then the Member with the potential conflict shall disclose the circumstances to the Advisor of the meeting, who shall upon discussion with the Co-Chair(s) of Girls Giving Grants, determine whether there exists a conflict of interest that is subject to this policy.

7. Violation of this Policy

a. If any Member of Girls Giving Grants has reasonable cause to believe that a Member has failed to disclose an actual or possible conflict of interest, she shall immediately inform any Advisor and the Co-Chair(s) of Girls Giving Grants of the basis for such belief. The Member with the possible conflict should then be afforded an opportunity to explain the alleged failure to disclose. 

b. If, after hearing the explanation provided by the Member who allegedly violated this policy, and making such further investigation as may be warranted in the circumstances, the Advisors and the Co-Chair(s) of Girls Giving Grants determines that the Member has, in fact, failed to disclose an actual or possible conflict of interest, it shall consider appropriate disciplinary and corrective action, including those listed in section 7c, below.

c. The violation of this Conflict of Interest Policy is a serious matter and may constitute cause for removal of the Member from the ARC for which she serves. It may also warrant dismissing the Grant Applicant involved from consideration for Girls Giving Grants’ grant award.

8. Confidentiality 

Each Member shall exercise care not to disclose confidential information (a) acquired in connection with such status, or (b) the disclosure of which might be adverse to the interests of Girls Giving Grants. Furthermore, no Member shall disclose or use information relating to the business of Girls Giving Grants for the personal profit or advantage of any Member, any Family Member, or any Grant Applicant.

We have reviewed and discussed this Policy and we understand that this policy is meant to supplement good judgment, and will respect its spirit as well as its wording.

If conflicts do exist, please disclose by completing the information below.

By signing below, you are indicating that you have read and discussed this Policy with your parent and/or legal guardian and you understand and agree to comply with Girls Giving Grants’ Conflict of Interest Policy. You are also agreeing to update this Disclosure Form as appropriate.