Volunteer Application Form - Bend Area Habitat For Humanity Office

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PLEASE READ CAREFULLY! THIS IS A LEGAL
DOCUMENT THAT AFFECTS YOUR LEGAL RIGHTS!
This Release & Waiver of Liability (the “Release”) executed on this _______________day of_________________ 2017
(PRINT YOUR NAME)_____________________________________________________________________________
in favor of Habitat for Humanity International, Inc., a nonprofit corporation, and Bend Area Habitat for Humanity, an Oregon, nonprofit
organization, their directors, officers, employees, and agents (collectively “Habitat”).
The Volunteer, who is at least 16 years old,
desires to work as a volunteer for Bend Area Habitat for Humanity, Bend and engage in the
activities related to being a volunteer (the “Activities”). The Volunteer understands that the Activities may include constructing and
rehabilitating residential buildings, working in the Habitat offices, and/or ReStore. Individuals between the ages of 9 and 16 years old may
volunteer at ReStore with prior authorization.
:
The volunteer hereby freely, voluntarily, and without duress executes this Release under the following terms
RELEASE & WAIVER:
Volunteer does hereby release and forever discharge and hold harmless Habitat and its successors and
assigns from any and all liability, claims, and demands of whatever kind or nature, either in law or in equity, which arise or may
hereafter arise from Volunteer’s Activities with Habitat.
Volunteer understands that this Release discharges Habitat from any
liability or claim that the Volunteer may have against Habitat with respect to any bodily injury, personal injury, illness, death, or
property damage that may result from Volunteer’s Activities with Habitat, whether caused by the negligence of Habitat or its officers, directors,
employees, or agents or otherwise. Volunteer also understands that Habitat does not assume any responsibility for or obligation to provide
.
financial assistance or other assistance, including but not limited to medical, health, or disability insurance in the event of injury or illness
MEDICAL TREATMENT:
Volunteer does hereby release and forever discharge Habitat from any claim whatsoever which arises or may
hereafter arise on account of any first aid, treatment, or service rendered in connection with the Volunteer’s Activities with Habitat.
ASSUMPTION OF THE RISK:
The Volunteer understands that the Activities include work that may be hazardous to the volunteer,
including, but not limited to, construction, loading and unloading, and transportation to and from the work sites.
Volunteer hereby expressly and specifically assumes the risk of injury or harm in the Activities and releases Habitat from all liability of injury,
illness, death, or property damage resulting from the Activities.
INSURANCE:
The Volunteer understands that, except as otherwise agreed to by Habitat in writing, Habitat does not carry or maintain health,
medical, or disability insurance coverage for any Volunteer.
EACH VOLUNTEER IS EXPECTED AND ENCOURAGED TO OBTAIN HIS/HER OWN MEDICAL OR HEALTH INSURANCE COVERAGE
PHOTOGRAPHIC RELEASE:
Volunteer does hereby grant and convey unto Habitat all right, title, and interest in any and all
photographic images and video or audio recordings made by Habitat during the Volunteer’s Activities with Habitat, including, but not limited to,
any royalties, proceeds, or other benefits derived from such photographs or recordings.
The following items are not permitted: Alcohol, tobacco products, illegal drugs, and fire arms are absolutely not permitted on the construction
.
site(s), at ReStore, or wherever Bend Habitat activities are taking place
OTHER:
Volunteer expressly agrees that this Release is intended to be as broad and inclusive as permitted by the laws of the State
of Oregon, and that this Release shall be governed by and interpreted in accordance with the laws of the State of Oregon. Volunteer
agrees that in the event that any clause or provision of this Release shall be held to be invalid by any court of competent jurisdiction, the
.
invalidity of such clause or provision shall not otherwise affect the remaining professions of this Release which shall continue to be enforceable
______ New Volunteer
______ Current Volunteer
______ Previous Volunteer
ADDRESS_____________________________________________
CITY_____________________
ZIP________________
PHONE_____________________________
EMAIL___________________________________________________
Volunteers under 18 must have LEGAL GUARDIAN SIGNATURE ___________________________________________________
VOLUNTEER SIGNATURE_____________________________________________
BIRTHDATE________________________
EMERGENCY CONTACT NAME __________________________________________
RELATIONSHIP __________________
PHONE ____________________________
Are you a member of Thrivent Financial? (We track this for grant purposes)
Yes
No
Are you volunteering as a result of a court-ordered service?
Yes # Hours________
No
*I have read and understand the BAHFH Code of Conduct (on reverse side.) ____________________ (Initials)
*This form must be signed and submitted to either Bend Area Habitat for Humanity Office

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