By signing below, I hereby agree to the following in connection with my volunteer activities for the Somerville Homeless Coalition, Inc. (“SHC”):

I desire to work as a volunteer for SHC. My participation with SHC is strictly voluntary and it is for my own personal and charitable purposes. I have no expectation of receiving any compensation for my time. I understand that my volunteer work may involve (but is not limited to) activities such as working at SHC offices; (“Activities”).

I understand that participation in the Activities may involve certain risks, which, while unlikely, could result in personal injury(ies), bodily injury, illness, permanent disability, property damage, loss and/or death. These risks include (but are not limited to) exposure to and/or infection with COVID-19 and/or other viruses and/or bacteria, even in ideal conditions and despite any efforts made to mitigate such risks. I further acknowledge and agree that, due to the nature of the Activities, social distancing of six feet per person will not always be possible and that my participation in the Activities may result in an elevated risk of contracting COVID-19 and/or other viral and/ or bacterial infection.

Indemnification, Release and Waiver of Liability. With informed consent, and in consideration of being allowed to participate in the Activities, I hereby on behalf of myself, my minor child(ren) who are present during the Activities, and anyone seeking to assert a claim by, through or under me: (a) irrevocably and unconditionally release SHC, and its respective past, present and future parents, affiliated entities, joint venturers, principals, members, partners, shareholders, donors, directors, trustees, officers, employees, volunteers, contractors, sponsors, vendors, suppliers, consultants, representatives, attorneys, insurers, agents, and assigns (collectively, “Released Parties”) from any and all manner of claims, complaints, demands, actions, causes or action, suits, judgments, damages and liabilities, of every kind and nature whatsoever, known or unknown, in connection with, by reason of, on account of, or arising out of my volunteer activities, including but not limited to any accident, injury, death, or harm to me or any other or damage to my property (collectively, “Liabilities”); and (b) shall defend, indemnify and hold all Released Parties harmless from and against any and all Liabilities. I understand this means that I am giving up the right to sue any Released Parties for, among other things, any injuries, damages, or losses I may incur, and that this indemnification and waiver of liability binds myself and my heirs, executors, administrators, legal representatives, and assigns.


Photographic/Recording Release. On my own behalf and on behalf of my minor child(ren) who are present during the Activities: I give permission and consent for SHC to photograph and make video/audio/electronic recordings of me and my minor child(ren), and to use the photographs and recordings in whole or in part, and my image, likeness, appearance, portraits, or voice, for any purpose, without compensation to me or the child(ren) now or in the future. I understand that SHC may copy or edit the recordings without my further permission. I hereby grant to SHC all right, title and interest in any and all such photographs and recordings, and to any royalties, proceeds or other benefits derived from them, and I waive all rights, privileges or claims based on any right of publicity, privacy, ownership or any otherwise arising from or relating to the photographs and recordings.

Acknowledgment. I acknowledge and agree that I am responsible to understand any potential dangers or risks that may be involved in with volunteer activities with SHC. I have had adequate opportunity to read and consider whether to sign this Volunteer Agreement, Release, and Waiver of Liability document, and I expressly agree that the releases and waivers herein are intended to be as broad and inclusive as permitted by Massachusetts law. I want to participate despite the possible dangers or risks and despite the requirement of the indemnification, releases and waiver of liability in this document.


I sign this Volunteer Agreement, Release, and Waiver of Liability freely, voluntarily and without duress, and I agree that it is effective as of the earlier of the date I sign it or my first participation in any Activities, and it will continue in full force and effect for so long as I have involvement with SHC.


Name and Contact Information of Volunteer:


IMPORTANT: If the volunteer is less than 18 years of age, all parents or guardians must read and sign below.


If only one parent or guardian signs these forms on behalf of a Volunteer who is under 18 years of age, then the undersigned parent or guardian of the Volunteer hereby covenants, warrants, represents and agrees that he or she is executing these forms on behalf of, and as an agent for, any other individual who may be a parent or guardian of the Volunteer, that he/she is fully authorized to do so, and that by executing such Release and Parental Authorization, the undersigned is binding himself/herself, the Volunteer, and any other parent or guardian of the Volunteer, and all of their heirs, next of kin, assigns, and legal representatives to such Release and Parental Authorization.




I have carefully considered my decision, the benefits and risks involved and hereby give my informed consent, on behalf of the above listed minor child, for him/her to participate in all Activities as set forth in the above Volunteer Agreement, Release, and Waiver of Liability. I have read and understand the above Volunteer Agreement, Release, and Waiver of Liability, any questions of mine have been answered, and I voluntarily agree to all such provisions. It is my intent to bind my and the minor Volunteer’s heirs, next of kin, assigns, and legal representatives. I understand that the above Volunteer Agreement, Release, and Waiver of Liability is made on behalf of my minor child(ren) and/or legal wards and I represent and warrant to SHC that I have the full authority to sign this on behalf of such minor(s).

Please select who will be participating...
First Participant's Name

First Name*

Middle Name

Last Name*

First Participant's Date of Birth*
First Participant's Signature*
Parent or Guardian's Email Address


Confirm Email*
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Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*

Emergency Contact's Relation to Participant
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*


Parent or Guardian's Date of Birth*
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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