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Goshala-BJ & Animal Care

Release and Waiver of Liability for Volunteers/Visitors


Volunteer Agreement As a volunteer at GOSHALA BJ ANIMAL CARE(GBJAC), I understand and agree to the following: 1. I agree to volunteer and donate my services, without expectation of payment, to the GBJAC, a California nonprofit public benefit organization. I am volunteering my services for public service and humanitarian objectives. I understand that I will receive no pay, benefits, or other privileges of employment of any kind for my services. I do not consider myself, and I understand that I am not an employee, agent, or representative of the GBJAC for any purpose, and I will not speak on behalf of the GBJAC or represent the Company to third parties unless authorized to do so. I understand and agree that either the Company or I may elect to terminate my volunteer services at any time for any reason. I agree to perform the services described in the attached Scope of Services, as well as other services assigned to me as appropriate. 2. Before beginning my volunteer work, the GBJAC staff person supervising my volunteer services will be responsible for advising me as to which Company policies and procedures specifically apply to my volunteer services so that I may familiarize myself with those policies and procedures. 3. I understand that the GBJAC will not carry or maintain health, malpractice, professional liability, medical, disability or other insurance coverage for me or other volunteers (regardless of whether GBJAC has any insurance policies that cover volunteer activities, I understand that those policies may not cover any loss, accident, obligation or other liability I incur while performing the volunteer services). I further understand that I am not eligible for workers’ compensation benefits if I am injured or become ill as a result of my volunteer work. During the period of my volunteer service, I agree that it is my responsibility to maintain personal medical insurance coverage. 4. With regard to my presence on GBJAC property, if applicable, and the volunteer services, I will be providing, I recognize and acknowledge that there are certain risks of physical injury, and I agree to assume the full risk of any bodily injuries, property damage, or loss, which I may sustain as a result of participating in any and all activities connected with or associated with my volunteering for GBJAC. I acknowledge that GBJAC makes no warranty or representation, express or implied, regarding the conditions that may be encountered during such volunteer services and/or with regard to any means of transportation to or from such activities, and that the GBJAC will have no liability for any defect or dangerous condition pertaining thereto. I agree to sign the attached form entitled “Release and Waiver of Responsibility'' form. 5. I understand and agree that I am not eligible for unemployment compensation benefits when my volunteer assignment ends. I also certify that I have not been promised and have no expectation that I will receive a paid position as a result of my volunteer services. 6. In the event of an emergency, I authorize the GBJAC officials to secure from a licensed hospital, physician, and/or medical personnel any treatment deemed necessary for my immediate care, and I agree that I will be responsible for payment of all such medical services rendered. 7. I agree to respect the privacy of our clients, donors, members, staff, volunteers, and GOSHALA BJ ANIMAL CARE, itself, as a basic value of GBJAC. Personal and financial information is confidential and should not be disclosed or discussed with anyone without permission or authorization from GBJAC. Care shall also be taken to ensure that unauthorized individuals do not overhear any discussion of confidential information and that documents containing confidential information are not left in the open or inadvertently shared. I agree that I may be exposed to information that is confidential and/or privileged and proprietary in nature. It is the policy of GOSHALA BJ ANIMAL CARE that such information must be kept confidential, both during and after the terms of this agreement. I am expected to return materials containing privileged or confidential information at the termination of this agreement. Unauthorized disclosure of confidential or privileged information is a serious violation of this policy and may result in the immediate termination of this agreement. 8. I understand that the GBJAC will retain the ownership intellectual property that I produce within the scope of my volunteer services and will retain sole discretion to publish any intellectual product except that I reserve the right to use non-confidential components of the produced intellectual property, as a sample of my work product upon the written approval of GBJAC. I understand this right of reproduction that I retain may be subject to redaction requirements. 9. I understand that the GBJAC will not reimburse for any expense without express prior approval, in writing, by the management of the Company. I understand that such expenses submitted by me for reimbursement by the Company shall be substantiated by proper and adequate documentation and receipts. Such expenses must be reasonable in amount, related to and in furtherance of my volunteer services. 10. This Agreement shall in all respects be interpreted, enforced, and governed by and the laws of the state of California. 11. I certify that I have the ability and legal right to volunteer in the United States of America for the duration of this volunteer assignment without any restriction and that I have chosen to accept this assignment on a complete volunteer basis. I have read and fully understand and agree to the terms of this Volunteer Agreement. I also understand that no changes shall be made to this document unless they are in writing and signed both by an authorized representative of GBJAC and by me. I affix my signature freely and willingly on the line below.

GOSHALA BJ ANIMAL CARE VISITOR AGREEMENT, RELEASE AND LIABILITY WAIVER(“AGREEMENT”)

Thank you for your interest in GOSHALA BJ ANIMAL CARE. Visits and tours are by appointment only (no drop-ins). We ask all visitors to respect the animals you encounter while visiting premises to learn more about GOSHALA and the wonderful animals who welcome you to their home. Before your visit, please read this Agreement and acknowledge the following by checking each box below: Note:

If you are under the age of 18, your parent or guardian must sign this Minor Agreement on your behalf. In consideration of being allowed to visit GOSHALA BJ ANIMA L CARE and intending to be legally bound, the undersigned (hereinafter “I” or “me”) agrees and affirms as follows: CONSENT TO PHOTOGRAPHS: By checking the box below: (1) I hereby grant permission to be photographed and/or videotaped during the course of normal activities during my visit to GOSHALA BJ ANIMAL CARE. (2) I further understand and agree that GOSHALA BJ ANIMAL CARE may use such photographs/videos with or without my name or permission and for any lawful purpose, including in advertisements and publicity posters, as well as on the GOSHALA BJ ANIMAL CARE website.




SAFETY PRECAUTIONS (FOR HUMANS AND OTHER ANIMALS): GOSHALA BJ ANIMAL CARE safety precautions must be strictly followed for the safety of every animal and a person. GOSHALA BJ ANIMAL CARE reserves the right to ask anyone to leave the property who fails to follow these rules and/or has agreed to be responsible to supervise a minor who fails to follow these rules. Please remember, SAFETY first. No rough housing, screaming, loud noises, or profanity. Wear sturdy boots or shoes to protect your feet, no sandals, flip flops etc. Do not enter any stall or pasture without permission. Always close the gate immediately behind you and be certain it is latched/locked properly. Do not enter any stalls or pastures unless invited by a staff member. Do not feed any animal anything (not even treats) without direct approval. The animals have special needs and restrictions to their diets. Do not handle any animal without direct authorization. Please no outside food due to food allergy safety risks. No smoking on sanctuary grounds. No alcohol or drug abuse while attending a GOSHALA BJ ANIMAL CARE related function. Those under age 18 must be supervised by a parent/guardian at all times. I have read and agree to follow the above Safety Precautions. 

RELEASE AND WAIVER OF RESPONSIBILITY Liability Release and Waiver I have volunteered to assist GOSHALA BJ ANIMAL CARE, a California nonprofit public benefit corporation GBJAC). I have volunteered my time and services because of my support for the GBJAC and my desire to participate actively in the furtherance of its work. For good and valuable consideration and in consideration of my participation in activities that can be dangerous, including, but not limited to vehicular, plane and other travel related to my volunteer duties and activities, and other work related to performing duties in an office or field setting, including for times I may visit GOSHALA BJ FACILITIES, I release GOSHALA BJ ANIMAL CARE, its present and former members, agents, employees, officers, directors, shareholders, affiliates, parent corporations, subsidiaries, representatives, attorneys, successors in interest, predecessors in interest, and assigns (collectively,GBJAC” or the “Releases'') of any and all claims for personal injury, property damage, or wrongful death arising out of or relating to any of myactivities. Because the assertion of claims against the GBJAC for personal injury occurring during my volunteer service would be antithetical to my support of the GBJAC and its goals and would reduce the ability of GBJAC to accomplish its charitable purposes, I grant this release. This Release and Waiver of Responsibility (“Release”) applies to any and all manner of actions and causes of actions, suits, debts, obligations, actions, contracts, covenants, warranties, claims, sums of money, judgments, demands, damages, and rights whatsoever in law or in equity, which have or may accrue in favor of myself against any one or more of the Releases, by reason of any facts or circumstances, known or unknown, suspected or unsuspected, or which may hereafter arise as a result of the discovery of new and/or additional facts, including, without limitation, those arising out of, on account of, based upon, or in any way relating to my activities. I expressly waive any and all benefits that would otherwise be available under any statute, legal decision, or common law principle with respect to unknown or suspected claims. I shall defend, indemnify, and hold Releases harmless from any and all claims of any person or entity to the extent that such claims arise from or relate to my activities. Media Release and Waiver I understand that during the course of my volunteer activity at GBJAC, I may encounter activities which are videos recorded, audio recorded, and/or photographed for the purpose of being used and distributed in various formats by GBJAC for educational, public awareness, and/or humanitarian objectives, including, but not limited to, classroom, television, the Internet (including webcasts, content postings, and podcasts), and any other communication medium currently existing or later created. I give my permission and authorize GBJAC to videotape, audiotape, photograph, record, edit, or otherwise reproduce my image in connection with my volunteer activities at the GBJAC and to use it in the formats and for the purposes stated above. I agree to indemnify and hold harmless the GBJAC, its employees, and representatives against any and all claims arising out of my volunteer services, including, but not limited to, claims of intellectual property infringement, defamation, and misrepresentation. I warrant and represent that I have carefully read this Release and any instructions provided by GBJAC concerning volunteer activities. Volunteers will not divulge any confidential information to anyone, within or outside the GBJAC, not authorized to receive such information. Confidential information is knowledge, records, or data, in any form (written, electronic, or oral) which GBJAC has a legitimate interest in protecting from unauthorized disclosure. Examples include contents of project files, strategic plans, terms and conditions of contracts completed or under negotiation, donor information (such as donor names, appraisals, and giving histories), employee salaries, contents of official personnel files, and sensitive data. Purpose To respect and assure the privacy of GBJAC employees, its donors, its partners, and its business associates. GOSHALA BJ ANIMALCARE(GBJAC)is committed to establishing and maintaining a work environment that fosters harmonious, productive working relationships and encourages mutual respect among colleagues. The Company is committed to providing a safe and welcoming work environment, free of unlawful harassment for all volunteers. The company takes these matters seriously and will take prompt and appropriate action to maintain a workplace free of any form of harassment. Company policy prohibits unlawful discrimination based on race, religion, sex, national origin, ethnicity, age, mental or physical disability, sexual orientation, gender (including pregnancy and gender expression) identity, color, marital status, veteran status, medical condition, genetic disposition, or any other classification protected by federal, state, or local ordinance. All such harassment is unlawful. The GBJAC volunteer anti-harassment policy applies to all persons involved in the GBJAC operation and prohibits unlawful harassment by any employee of the GBJAC, including supervisors and managers, as well as vendors, clients, independent contractors, volunteers, and any other people doing business with GBJAC. GBJAC also prohibits unlawful harassment based on the perception that anyone has any of these characteristics or is associated with a person who has or is perceived as having any of those characteristics or conditions

Today's date: July 26, 2024

Signature of Volunteer/Visitor


First Participant's Name

First Name*

Last Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information by e-mail.
Please upload your picture so we can identify you during volunteer events. Selfie time!
  
Click to customize text box label *
Valid file types: JPG, GIF, PNG, and PDF
Please provide a mobile number for communication about the field events updates or changes.

Phone Number: *
For Reserved groups- Please provide the name of the organization.

Coming in with a specific group/organization for e.g. Sunday school, language classes etc? Please provide the name of the organization. If not, please write n/a *
Adults ages 18 years and over, please choose your Volunteer designation.
Please choose your designation.*
Corporate Volunteer(Field event)
Corporate Volunteer (Remote)
Adult 18 years & over
For Corporate volunteers, please choose your employer.

Please list the name of the corporate.
Please list the age group of minor(s) attending the event
Please choose the age of minors attending the field events.
Kids ages 0-5 years old.
Kids ages 5-10 old.
Kids ages 10-15 years old.
Kids ages 15-18 years old
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(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.


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