Cobb County School District "Blanket" Permission To Participate Form/medical History Permission And Release Form/etc. Page 5

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NW Metro Atlanta Habitat for Humanity
9/18/07
Release and Waiver of Liability
PLEASE READ CAREFULLY!
THIS IS A LEGAL DOCUMENT THAT AFFECTS YOUR LEGAL RIGHTS!
This Release and Waiver of Liability (the “Release”) is executed on this _____ day of _______________, 20___,
by __________________________, (the “Volunteer”), in favor of [NW Metro Atlanta Habitat ], Habitat for
Humanity International, Inc., and any other Habitat for Humanity affiliated organization and their respective
directors, officers, trustees, employees, volunteers and agents (collectively, the “Released Parties”).
I, the Volunteer, desire to work as a volunteer for one or more of the Released Parties and engage in the
activities related to being a volunteer ("Activities"). I understand that my Activities may include but are not
limited to the following: working in Habitat for Humanity offices or Habitat for Humanity ReStore operations;
traveling to and from work sites, towns, cities or countries; consuming food available or provided; living in
housing provided for volunteers; constructing and rehabilitating residential buildings; and other construction-
related activities.
I, the Volunteer, hereby freely, voluntarily and without duress execute this Release under the following terms:
Release and Waiver. I, the Volunteer, do hereby release and forever discharge and hold harmless the
Released Parties and their successors and assigns from any and all liability, claims and demands which I or
my heirs, assigns, next of kin or legal representatives may have or which may hereinafter accrue with respect
to any bodily injury, personal injury, illness, death or property damage which arise or may hereafter arise
from or is in any way related to my Activities with any of the Released Parties, whether caused wholly or in
part by the simple negligence, fault or other misconduct, other than intentional or grossly negligent conduct,
of any of the Released Parties or of other volunteers.
I understand and acknowledge that by this Release I knowingly assume the risk of injury, harm and loss
associated with the Activities. I also understand that the Released Parties do 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, illness, death or property damage.
It is the policy of Habitat for Humanity that children under the age of 16 are not allowed on Habitat for
Humanity worksites while construction is in progress. It is further the policy of Habitat for Humanity that,
while minors between the ages of 16 and 18 may be allowed to participate in construction work, using power
tools, excavation, demolition, working on rooftops and similar activities are not permitted for anyone under the
age of 18.
Medical Treatment. I, the Volunteer, do hereby release and forever discharge the Released Parties from
any claim or action whatsoever which arises or may hereafter arise on account of any first aid, treatment or
service rendered in connection with my Activities with any of the Released Parties.
If the Volunteer is less than 18 years of age, the Volunteer and the parents having legal custody and/or the
legal guardians of the Volunteer (the “Guardians”) also hereby release and forever discharge the Released
Parties from any claim whatsoever which arises or may hereafter arise on account of the decision by any
representative or agent of the Released Parties to exercise the power to consent to medical or dental treatment
as such power may be granted and authorized in a Parental Authorization for Treatment of a Minor Child.
Assumption of the Risk. I, the Volunteer, understand that my Activities may include work that may be
hazardous to me, including, but not limited to, the following: construction; loading and unloading; travel to
Page 5 of 7
Waiver/Release Form v4.2014

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