Litter Free Upland

Volunteer Release & Waiver of Liability

Required by Upland Acts of Service for all volunteers.

Please read carefully! This is a legal document that affects your legal rights.

I want to participate in volunteer activities for Litter Free Upland, henceforth referred to as LFU. As a LFU volunteer, I freely, voluntarily, and without duress execute this Release and Waiver under the following terms:

1. Assumption of Risk

I understand that my work for LFU may include activities that are hazardous and/or physically strenuous and that I may be exposed to personal injury or damage to my property as a result of my activities, the activities of other persons, or the conditions under which my services are performed while participating in LFU volunteer activities. Though LFU will provide me with support, supervision, training, and supplies to accomplish assigned tasks, I agree to the required acknowledgements below:

2. Indemnity

I hereby agree to defend, indemnify, save and hold free and harmless LFU and its officials, officers, employees, volunteers and agents from any and all liability from loss, damage, cost or injury, including wrongful death, to any property or persons, including third parties, in any manner arising out of or incident to any acts, omissions or willful misconduct of me while I participate in the volunteer activities, whether or not while using LFU equipment, supplies and apparatus, including without limitation the payment of attorneys' fees. Further, I shall defend at my own expense, including attorneys' fees, LFU and its officials, officers, employees, volunteers and agents in any action or proceeding, legal, administrative or otherwise, based upon such acts, omissions or willful misconduct. I agree to accept and assume full responsibility for any and all risks of damage, injury, or death resulting to me while participating in the volunteer activities, whether or not while using LFU equipment, supplies and apparatus, whether the risks are known or unknown to me.

3. Waiver and Release

I hereby agree, that in consideration for LFU allowing me to participate in the volunteer activities, that I, my personal representatives, heirs, next-of-kin and assigns (collectively the “Releasors”) hereby release, waive, discharge and covenant not to sue LFU and its officials, officers, employees, volunteers and agents from and for any and all liability for any loss or damage to me or the other Releasors, and from and for any claim or demands therefor on account of injury to the person or property of me or the other Releasors, including death, whether caused by the negligence of me, LFU, other participants in the volunteer activities, or anyone else while I participate in the volunteer activities, whether or not using LFU equipment, supplies and apparatus, whether the risks are known or unknown to me.

4. Medical Treatment

I release and discharge LFU from any claim that arises or may arise due to any first aid, medical treatment, or service rendered to me.

5. Insurance

Litter Free Upland does not have responsibility for providing any health, medical or disability insurance coverage for me. IT IS MY RESPONSIBILITY AS A VOLUNTEER TO ENSURE I HAVE MEDICAL/HEALTH INSURANCE.

6. Photographic Release

I grant to LFU the right to use photographic images and video or audio recordings of me that are made by LFU or others during my volunteer work for LFU.

7. Severability

I agree that this Release and Waiver is intended to be as broad and inclusive as permitted by the laws of California and that this Release and Waiver is governed by and will be interpreted according to the laws of California. I understand that should any part of this Release and Waiver be ruled invalid by a court, the other parts will remain valid and continue to be in effect.

Certification and signature

I HAVE CAREFULLY READ, UNDERSTAND, ACKNOWLEDGE AND AGREE TO THIS RELEASE OF LIABILITY. I UNDERSTAND THAT I AM GIVING UP VALUABLE LEGAL RIGHTS BY SIGNING THIS FORM. I HAVE AGREED TO SIGN THIS CERTIFICATION OF MY OWN FREE WILL. I CERTIFY THAT I AM AT LEAST EIGHTEEN (18) YEARS OF AGE OR HAVE HAD THIS DOCUMENT SIGNED BY MY PARENT OR GUARDIAN. I UNDERSTAND THAT I MAY SEEK THE ADVICE OF AN ATTORNEY IN ANY MATTER CONNECTED WITH THIS FORM BEFORE SIGNING.

Required acknowledgements — select each statement after reading the waiver

I will follow all instructions provided by the LFU leadership, its employees, or volunteer coordinators.

I will only use equipment that I know how to operate and use safely.

I will not undertake any activity for which I do not feel sufficiently prepared or able and until I have received instructions.

I will take all reasonable precautions to avoid injury to myself and to others and damage to property.

Finally, I agree to assume the risk of injury or harm and release LFU, its officers, directors, employees, and other LFU volunteers from all liability for injury, illness, death, or property damage arising from my work as a volunteer.

I understand that if I drive my personal vehicle for LFU business while volunteering, I must have a valid driver’s license and proof of auto insurance.

Volunteer Name

Volunteer Email

Volunteer Date of Birth required

Volunteer Phone Number

Parent/guardian if under 18; address for all

Parent/Guardian Name (for a minor)

Street address (optional) — Address information may help us with future grants by showing the community we serve.

City, state, ZIP (optional)

Emergency Contact Name

Emergency Contact Number

I have read and agree to the newVolunteer Release & Waiver of Liability

I have read and agree to the photographic release in Section 6 of the waiver.

Signature of adult participant or parent/guardian (draw with finger or mouse)

I agree to use an e-signature in lieu of physical signature

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