Applicant Disclosure and Release of Liability
I understand that, as a Volunteer for Warm Beach Christian Camps and Conference Center (Warm Beach Camp), I will be required to abide by all the same company policies, standards, and regulations, as declared from time to time, as is a paid employee. I understand that this is an application for Volunteer Status, and that no contract or remuneration is implied or sought. Pursuant to RCW 9A.73.085, I certify under penalty of perjury under the laws of the State of Washington that I have never been convicted of any crimes against persons as defined in Section 1 of Chapter 486, laws of 1987, and listed as follows: Aggravated murder, first or second degree murder, first or second degree kidnapping; first, second, or third degree assault; first, second, or third degree rape; first, second, or third degree statutory rape; first or second degree robbery; first degree arson; first degree burglary; first, second, or third degree manslaughter; first or second degree extortion; indecent liberties; incest; vehicular homicide; first degree promoting prostitution; communication with a minor; unlawful imprisonment; simple assault; sexual exploitation of minors; first or second degree criminal mistreatment.
Release/Participation: I am the participant or the parent/guardian of the participant. I agree or give permission for my child to participate in Warm Beach Camp activities including transportation in the role of volunteer staff. These may include field games, swimming, BB guns, archery, canoeing, climbing tower, high ropes course, and horseback riding. While Warm Beach Camp will provide for adequate and reasonable staff training and participant safety, I understand that accidents can sometimes happen. I am not relying upon Warm Beach Camp to list all possible risks. Therefore, in exchange for Warm Beach Camp allowing me or my child to volunteer, I understand and expressly acknowledge that I release Warm Beach Camp, its employees, board of directors, volunteers, or guests from all liability for any injury, loss or damage connected in any way whatsoever to participation in Warm Beach Camp activities whether on or off Warm Beach Camp’s premises and including transportation. I understand that this release includes any claims based on negligence, action or inaction of Warm Beach Camp, its employees, board of directors, volunteers, or guests.
Medical Treatment: In the event of an emergency, I give permission for the Warm Beach Camp staff or camp nurse to follow the physician’s standing orders for care and treatment of me or my child. I give permission to the physician selected by Warm Beach Camp to provide emergency medical treatment for me or my child and to transport them to an emergency center for treatment. I understand that this emergency care may require the physician to hospitalize, secure proper treatment for, and to order injections, anesthesia, or surgery for the participant named on this form. I understand that every effort will be made to notify the parent or guardian of the participant when medical attention is required at a hospital or clinic.
Self-Medication: I request that the person named above be permitted to carry medication on his/her person and/or keep them securely stored as I consider him/her responsible. He/she has been instructed in and understands the purpose and appropriate method and frequency of use. I understand, that in making this request, the Warm Beach Camp nurse will not be administering this medication to me or my child and is not responsible for loss, theft or misuse.
Insurance: I understand that Warm Beach Camp only provides Washington State Labor and Industries Worker’s Compensation Insurance for claims that occurred as a direct result of a volunteer’s service. Claims resulting from personal illness and/or personal injuries occurring during off hours would be the responsibility of private personal insurance not Warm Beach Camp.
Photo/Video Permission: I give permission for Warm Beach Camp to use, without limitations or obligation, photographs, film footage or tape recordings which may include my/my child’s image, voice, or artwork for the purposes of promoting or interpreting Warm Beach Camp’s programs.
Important Note: By continuing, you understand that if you do not want your photo/videos, etc. taken and/or used for the purposes listed above, it is your responsibility to let the photographer(s)/ videographer(s) know at the time the photos/videos are being taken.
I, hereby authorize Warm Beach Christian Camps and Conference Center (the Camp) and/or its agents to make anindependent investigation of my background, references, character, past employment, education, criminal or police records, including those maintained by both public and private organizationsand all public records for the purpose of confirming the information contained on my Application and/or obtaining other information, which may be material to my qualifications as avolunteer or for employment now, and if applicable, during the tenure of my volunteering or employment with the Camp.
I release the Camp and/or its agents and any person or entity, which provides information pursuant to this authorization, from any and all liabilities, claims, or lawsuits in regards to the information obtained from any and all of the above referenced sources used.
This authorization shall continue to be effective until revoked by me. A photocopy or facsimile copy of this consent shall be as effective as the original. The following is my true and complete legal name, and all information provided is true and correct to the best of my knowledge.
I hereby affirm and acknowledge, by signing immediately below, that all of the information provided and all of my answers to the foregoing questions are true and complete, and that any misrepresentation or omission may be grounds for rejection or dismissal of said Volunteer status.