Loading...

1641 Portland Ave.
Louisville, KY 40203
T: 502-791-0966
E: info@louisvillegrows.org
W: www.louisvillegrows.org 

Waiver of Liability and Hold Harmless/Indemnification Clause/Photo Release 

I have volunteered to assist Louisville Grows Inc., a 501c3 nonprofit corporation. I am volunteering my time and services to Louisville Grows. I understand that my activities as a volunteer include strenuous manual labor. I expressly assume all risks associated with or arising from my volunteer activities. Because the assertion of claims against Louisville grows Inc. for personal injury occurring during my volunteer service would be antithetical to my support of Louisville grows and its goals and would reduce the ability of Louisville Grows to accomplish its charitable purposes, I grant this release. I agree to abide by all rules and regulations of Louisville Grows regarding safety and use of all equipment.

On my behalf, my estate and the personal representative thereof, my heirs and assigns, I hereby forever release Louisville Grows, its officers, directors, employees and agents, from any and all costs, claims, losses, liabilities or damages arising from or in any way related to my service as a volunteer. I intend this release to be effective, regardless of whether claim of liability is asserted in negligence, strict liability in tort, or other theory of recovery. For myself, my estate and personal representative thereof, my heirs and assigns, I covenant and agree to make no claim, nor institute any suit, action or proceeding against Louisville Grows, its officers, directors, employees or agents, relating to any action, incident or occurrence arising from, or in connection with, my volunteer activities.

Photo Release
Louisville Grows Inc. has my expressed permission to use and/or replicate photographs and video taken of me during my work and/or volunteer services, or during any public events hosted by their organization, for the purpose of publishing in newsletters, their organization’s website, as well as for fundraising, outreach, and educational materials. Louisville Grows also has my expressed permission to use my name to identify my participation in work and/or volunteer services, or during any public events hosted by their organization. 

Dated: April 25, 2024

First Volunteer's Name

First Name*

Last Name*

Phone*
First Volunteer's Age Acknowledgment*
First Volunteer's Date of Birth*
I certify that I am 18 years of age or older
First Volunteer's Signature*
Second Volunteer's Name

First Name*

Last Name*
Second Volunteer's Date of Birth*
Third Volunteer's Name

First Name*

Last Name*
Third Volunteer's Date of Birth*
Fourth Volunteer's Name

First Name*

Last Name*
Fourth Volunteer's Date of Birth*
Fifth Volunteer's Name

First Name*

Last Name*
Fifth Volunteer's Date of Birth*
Sixth Volunteer's Name

First Name*

Last Name*
Sixth Volunteer's Date of Birth*
Seventh Volunteer's Name

First Name*

Last Name*
Seventh Volunteer's Date of Birth*
Eighth Volunteer's Name

First Name*

Last Name*
Eighth Volunteer's Date of Birth*
Ninth Volunteer's Name

First Name*

Last Name*
Ninth Volunteer's Date of Birth*
Tenth Volunteer's Name

First Name*

Last Name*
Tenth Volunteer's Date of Birth*
Volunteer's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive our E-Newsletter.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!