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Boy With A Ball Volunteer Release Form

Liability/Media/Medical/Covid Release


By signing this form, I knowingly and without duress execute this Release to engage in activities related to being such a volunteer (the “Activities”) under the terms below and in consideration of the services performed by Boy With A Ball (the “Organization”).


Liability Release​: I am voluntarily participating in the Organization’s Activities and agree to assume any and all risks of bodily injury, death or property damage, whether those risks are known or unknown.

I forever release and covenant not to sue the Organization and their respective current, past, and future directors, officers, board members, employees, volunteers, agents, contractors, and representatives (collectively “Releasees”) from any and all actions, claims, or demands that I, my assignees, heirs, distributees, guardians, next of kin, spouse and legal representatives now have, or may have in the future, for injury, death, or property damage, related to (i) my participation in these Activities, (ii) the negligence or other acts, whether directly connected to these Activities or not, and however caused, by any Releasee, or (iii) the condition of the premises where these Activities occur, whether or not I am then participating in the Activities. I also agree that I, my assignees, heirs, distributees, guardians, next of kin, spouse and legal representatives will not make a claim against, sue, or attach the property of any Releasee in connection with any of the matters covered by the foregoing release.

Media Release​: I hereby grant and convey to the Organization all right, title and interest in any and all photographic images and video or audio recordings made by or for the Organization during my participation in the Activities, including, but not limited to any royalties, proceeds or other benefits derived from such images or recordings.

Medical Release​: I hereby release and covenant not to sue the Organization from any and all liability which arises or may arise from any medical service rendered in connection with the Activities. I also understand that I am responsible for any and all charges as a result of such care or medical treatment.

I expressly agree that this Release is intended to be as abroad and inclusive as permitted by the laws of the state of Georgia, and that this Release will be governed by and interpreted in accordance with the laws of the state of Georgia without giving effect to its conflict of laws rules. I agree that in the event that any clause or provision of this Release is held to be invalid by any court of competent jurisdiction, the invalidity of that clause or provision will not affect the remaining provisions of this Release, which will continue to be enforceable.

Covid Release: I here by attest that I am not experiencing any symptoms of illness such as a fever, cough, or shortness of breath. If I develop these symptoms, I agree that I will cancel my shift before arriving to volunteer with Boy With a Ball (BWAB). I am aware that I must follow the safety and hygiene protocols that have been implemented by Boy With a Ball.

  • Assumption of Risk: I understand that my volunteer activities with BWAB may include activities that could be hazardous to me, including but not limited to packing, loading, unloading and carrying heavy items, transportation to and from work sites, and exposure to people with infectious diseases. I fully understand and appreciate the risks that are inherent to my volunteer activities.I hereby assume the risk of bodily injury, illness, death, medical treatment resulting from my volunteer activities even if resulting from the negligence of BWAB or its senior directors, employees or clients.
  • Follow the Rules: We will follow the direction being given by our local and national government and comply with it if at all possible. If authorities are asking us to not meet in  groups bigger than ten, we will adjust programming to reflect that. If a stay-at-home order is in effect, all volunteers and interns will be asked to work remotely. 
  •  If You Touch Sickness, Stay Home!: If anyone is sick, has symptoms, or has been close to someone who is sick, alert the authorities and quarantine yourself. Remain in quarantine at least 5 days or longer depending on symptoms. Your job is to get well! 
  • Office Cleanliness & Safety: Employees and interns will be asked to wash their hands as they enter the office and frequently throughout the day, and are encouraged to wear masks. Social distancing will be in effect, maintaining at least 6 feet of distance. Additionally, where possible, activities will take place outdoors. The office will be deep cleaned once a week, and all employees and interns will be asked to ensure their work area is sanitized at the end of each day. 
  •  Work Creatively: We will need to be creative in order to be both compliant to any restrictions, but to continue to serve young people and their families. We will work together as a team to create a strategy to stay connected and to care. If anything, this approach can allow us to be even more connected and intentional than we would usually be. There are many administrative tasks that can be performed remotely as well as many meetings that can be/will be moved to Zoom calls. 
  •  I attest that: I have not traveled internationally in the past 14 days and will inform BWAB if international travel occurs. I have not traveled to a highly impacted area within the  United States in the past 14 days and will inform BWAB if travel to a highly impacted area occurs. I do not believe that I have been exposed to a person with a confirmed or suspected case of COVID-19. I have not been diagnosed with COVID-19. I have been diagnosed with COVID-19, but cleared as non contagious by state or local public health authoritiesI am following recommended guidelines as much as possible - practicing social distancing by participating in group activities of fewer than 10, trying to maintain separation of six feet from others, and otherwise limiting my exposure to the coronavirus.

I have carefully read this agreement and fully understand and agree to its contents. I am aware that this is a release of liability and sign it of my own free will.

Date: May 5, 2024 

 


First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information

Home Phone Number: (unless already entered)

How did you hear about Boy With a Ball?

Email Address (*this field for minor's email only - if filling out for yourself, please disregard)
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

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

Home Phone Number: (unless already entered)

How did you hear about Boy With a Ball?

Email Address (*this field for minor's email only - if filling out for yourself, please disregard)
Third Participant's Name

First Name*

Middle Name

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

Home Phone Number: (unless already entered)

How did you hear about Boy With a Ball?

Email Address (*this field for minor's email only - if filling out for yourself, please disregard)
Fourth Participant's Name

First Name*

Middle Name

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

Home Phone Number: (unless already entered)

How did you hear about Boy With a Ball?

Email Address (*this field for minor's email only - if filling out for yourself, please disregard)
Fifth Participant's Name

First Name*

Middle Name

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

Home Phone Number: (unless already entered)

How did you hear about Boy With a Ball?

Email Address (*this field for minor's email only - if filling out for yourself, please disregard)
Sixth Participant's Name

First Name*

Middle Name

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

Home Phone Number: (unless already entered)

How did you hear about Boy With a Ball?

Email Address (*this field for minor's email only - if filling out for yourself, please disregard)
Seventh Participant's Name

First Name*

Middle Name

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

Home Phone Number: (unless already entered)

How did you hear about Boy With a Ball?

Email Address (*this field for minor's email only - if filling out for yourself, please disregard)
Eighth Participant's Name

First Name*

Middle Name

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

Home Phone Number: (unless already entered)

How did you hear about Boy With a Ball?

Email Address (*this field for minor's email only - if filling out for yourself, please disregard)
Ninth Participant's Name

First Name*

Middle Name

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

Home Phone Number: (unless already entered)

How did you hear about Boy With a Ball?

Email Address (*this field for minor's email only - if filling out for yourself, please disregard)
Tenth Participant's Name

First Name*

Middle Name

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

Home Phone Number: (unless already entered)

How did you hear about Boy With a Ball?

Email Address (*this field for minor's email only - if filling out for yourself, please disregard)
Participant'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 stay up to date on volunteer opportunities and other BWAB happenings.
Emergency Information

In Case of Emergency Contact: 


1st Choice:

Phone:

2nd Choice:

Phone:
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*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

Home Phone Number: (unless already entered)

How did you hear about Boy With a Ball?

Email Address (*this field for minor's email only - if filling out for yourself, please disregard)
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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