Volunteer Release Form for Minors
Parent Consent Form
(To be completed and signed by parent/guardian if volunteer is under 18 years of age)
Event/Activity: ________________________________________________________________ Date: ______________
Volunteer’s Name: ___________________________ Address: _____________________________________________
Email: _____________________________________________ Phone: _______________ Cell Phone: ______________
Health & Accident Insurance Contact: _________________________________________ Policy #: ________________
Emergency Contact Name: ____________________________ Relationship: ___________Phone: _________________
I, ________________________________, being the Parent or Legal Guardian of ______________________________
(The Minor), hereby consent to and authorize the Minor to act as a volunteer for the California State University,
I acknowledge and agree that activities performed by the Minor as a volunteer will be performed strictly on a
voluntary basis, without any pay, compensation, or benefits. I agree and understand that the Minor must comply with
the rules and regulations established from time to time by the California State University, Northridge and that failure
to do so may result in the Minor’s immediate removal as a volunteer.
I am aware of the nature of the activities to be performed by the Minor as a volunteer. These activities will include,
but are not limited to the duties listed on the Volunteer Form. I agree that all volunteer activities are to be performed
by the Minor at the Minor’s risk and I assume full responsibility therefore.
On behalf of myself, the Minor, and our respective heirs and personal representatives, I agree to indemnify and hold
the State of California, the Trustees of the California State University, Northridge and all of its officers, employees,
representatives and volunteers free and harmless from and against all claims, damages, losses and expenses,
including attorney fees, that my minor child may sustain while participating in the volunteer activity. I hereby release
and discharge the CSU and the Trustees of the California State University, Northridge and all of its officers,
employees, representatives and volunteers from any and all claims, demands, causes of action of any nature or cause,
for any such injury or damage incurred or suffered by the Minor.
Parent/Legal Guardian Signature
I have carefully read this agreement, waiver and release and fully understand its contents. I am aware that this is a
release of liability and a contract between the Northridge campus and myself and I sign it of my own free will.
Signature: ______________________________ Print Name: ____________________________ Date: _____________