Loading...

Rosie’s Farm Sanctuary
Volunteer Waiver, Consent, and Release of Liability

 

Read Carefully Before Signing:

I hereby consent to permit Rosie’s Farm Sanctuary, Inc. (Rosie’s) to contact anyone it deems appropriate to investigate or verify any information provided by me to discuss my suitability for a volunteer position, including my background, volunteer experience, education, or related matters. I expressly give my consent to any discussions regarding the foregoing, and I voluntarily and knowingly waive all rights to bring an action for defamation, invasion of privacy, or similar cause of action, against anyone providing such information.

I hereby authorize any organization affiliated with Rosie’s to investigate my background as necessary, and specifically, require fingerprinting for the consideration of my enrollment with any position that interacts with children. I further authorize all persons, schools, companies, organizations, credit bureaus, and law enforcement agencies to supply all information concerning my background and to furnish reports thereon. I hereby release them and any organization affiliated with Rosie’s from any and all liability and responsibility arising from their doing so.

Rosie’s has my permission, both during and anytime after my participation, to use my likeness, name, voice, or words on either social media, website, television, radio, film, newspapers, magazines, and other media, and in any form, for the purpose of advertising or communicating the purposes and activities of Rosie’s and applying for funds to support these purposes and activities.

I certify that I am physically fit for the activities I participate in and have not been advised to not participate by a qualified medical professional.  I certify that there are no health-related reasons or problems that preclude my participation in these activities.

If during my participation in Rosie’s activities I should need emergency medical treatment and I am not able to give my consent or make my own arrangements for that treatment because of my injuries, I authorize Rosie’s to take whatever measures are necessary to protect my health and well-being, including, if necessary, hospitalization.

I hereby acknowledge and assume the risk of participating in volunteer activities at Rosie’s, a farm sanctuary. I acknowledge that these activities may involve a test of a person’s physical and mental limits and carries with it the potential for death, serious injury, and property loss.  I understand there are inherent risks involved with these activities, which may include, but are not limited to:  exposure to varying weather conditions; harmful plants, insects, and animals; uneven terrain; farm equipment; unpredictable animal behavior; dehydration; and other hazards associated with a farm. I hereby acknowledge my understanding and acceptance of these risks and hereby indemnify, release, and hold harmless Rosie’s, its Board of Directors, officers, employees, volunteers, advisors, and representatives from any claims for injury, damage, or loss to person or property that may result from my volunteer participation at Rosie’s.

This Volunteer Waiver, Consent, and Release of Liability must be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law; however, it must not extend to any claims not permitted to be released by state law.

I hereby further acknowledge and understand that Rosie’s does not offer any health or medical insurance to volunteers and that I am encouraged to have my own health/accidental insurance coverage. I also understand and agree that I am personally responsible and liable for medical treatment and all related costs in the event of an injury to myself as a result of my participation in volunteer activities at Rosie’s.

I certify that the answers given by me on all forms are, to the best of my knowledge and belief, true and correct and that I have not knowingly withheld any pertinent facts or circumstances. I understand that any omission or misrepresentation of fact on any forms may result in refusal of or separation from volunteer service upon discovery thereof.

BY SIGNING, I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ALL OF ITS TERMS.  I AM AWARE THAT THIS IS A WAIVER, CONSENT, RELEASE OF LIABILITY, AND A CONTRACT AND, IF I SIGN, I AM VOLUNTARILY GIVING UP SUBSTANTIAL LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE.  I SIGN THIS DOCUMENT OF MY OWN FREE WILL.

Signature of Volunteer OR Parent / Legal Guardian (If volunteer is a minor or lacks legal capacity): 

Date: May 5, 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*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
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(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!