Loading...

FDRD Volunteer Release, Waiver and Assumption of Risk for Volunteer Participation

THIS IS A LEGALLY  BINDING RELEASE, WAIVER AND ASSUMPTION OF RISK, PLEASE READ CAREFULLY.


This legally binding RELEASE, WAIVER AND ASSUMPTION OF RISK FOR VOLUNTEER PARTICIPATION (Volunteer Waiver) is made by me to the Friends of the Dillon Ranger District (FDRD), its Partner Organizations (Partners) and each of their employees, agents, directors, officers, volunteers and insurers, together with each of their respective successors and assigns (Released Parties), in consideration for my intended participation in a volunteer project(s) or event(s) organized by FDRD and/or its Partners (Events).

I certify that I am at least 18 years of age (or, if I am younger than 18 years of age, my parent or guardian must also sign this Release of Liability) and in good health. I have no allergy, illness or other disorder that could prevent me from participating in the Events. I realize that my participation in an Event may involve using heavy tools and that I will be working with other participants who may not be accustomed to this kind of labor. I FULLY REALIZE THE DANGERS OF PARTICIPATING IN EVENTS OF THIS TYPE AND VOLUNTARILY ASSUME ALL THE RISKS ASSOCIATED WITH SUCH PARTICIPATION. I understand the risks of participation in the Events may include, by way of example and not limitation, the following: rock fall, rock and snow slides, lightning, sudden changes in weather, altitude sickness, dehydration, COVID-19, drowning, hypothermia, automobile and vehicular accidents, operation of heavy equipment, injuries resulting from heavy labor or trail tools by me and others, insect stings, snakebite, falling trees and aggressive wildlife; and I will not hold FDRD, any of the Released Parties responsible for these or other hazards. Because the Event may occur in a backcountry setting, I understand that emergency medical care and cellular service may not be readily available. I will follow all directions from FDRD personnel and comply with all directions applicable rules for volunteers working with the Events. In return for my receiving permission from FDRD and its Partners to participate in the Events, and for other good and valuable consideration, I fully release, indemnify, defend and hold harmless the Released Parties from any and all liability, injury, debts, claims, demands, and causes of action of any kind whatsoever, specifically any claim for negligence or negligent acts or omissions, arising out of damage, loss, or injury to me (including death), to my property, or to any other person or property for which I may be liable, from whatever cause, as a result of my participation in the Event. I intend this Volunteer Waiver to be broadly construed for the benefit of the Released Parties and to be binding upon my family, heirs, personal representatives, assigns and insurers. I grant FDRD and other sponsoring organizations permission to use my image in photographic or video recordings of the project, and I waive any right to compensation for such use.

I HAVE CAREFULLY READ THIS FORM AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THIS FORM IS A RELEASE OF LIABILITY, AN AGREEMENT TO HOLD HARMLESS AND INDEMNIFY, A WAIVER OF CLAIMS, AN AGREEMENT NOT TO SUE, AND A CONTRACT BETWEEN MYSELF AND THE FRIENDS OF THE DILLON RANGER DISTRICT AND FOR THE BENEFIT OF THE RELEASED PARTIES, I SIGN IT OF MY OWN FREE WILL.

December 3, 2023



First Participant's Name

First Name*

Last Name*

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

ALLERGIES:

MEDICATIONS:
First Participant's Signature*
Second Participant's Name

First Name*

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

ALLERGIES:

MEDICATIONS:
Third Participant's Name

First Name*

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

ALLERGIES:

MEDICATIONS:
Fourth Participant's Name

First Name*

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

ALLERGIES:

MEDICATIONS:
Fifth Participant's Name

First Name*

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

ALLERGIES:

MEDICATIONS:
Sixth Participant's Name

First Name*

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

ALLERGIES:

MEDICATIONS:
Seventh Participant's Name

First Name*

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

ALLERGIES:

MEDICATIONS:
Eighth Participant's Name

First Name*

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

ALLERGIES:

MEDICATIONS:
Ninth Participant's Name

First Name*

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

ALLERGIES:

MEDICATIONS:
Tenth Participant's Name

First Name*

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

ALLERGIES:

MEDICATIONS:
Parent or Guardian's Email Address

Email*

Confirm Email*
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:
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*

IF VOLUNTEER IS UNDER 18, PARENT OR GUARDIAN MUST READ AND SIGN BELOW

I am the parent or legal guardian of the minor who signed this Release of Liability, which I have read. I consent to its terms on behalf of the above named minor and also consent to his or her participation in the activities referred to above.

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 Date of Birth*
Parent or Guardian's Information

ALLERGIES:

MEDICATIONS:
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!