Loading...

FDRD Volunteer Release of Liability

THIS IS A LEGAL CONTRACT WITH LEGAL CONSEQUENCES, PLEASE READ CAREFULLY.

I, would like to work as a volunteer this summer with Friends of the Dillon Ranger District (FDRD). 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 working safely as a volunteer. I realize that my participation in an FDRD program 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 AN EVENT OF THIS TYPE AND VOLUNTARILY ASSUME ALL THE RISKS ASSOCIATED WITH SUCH PARTICIPATION. I understand the risks 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, injuries resulting from heavy labor or trail tools, falling trees and aggressive wildlife; and I will not hold FDRD, any of its volunteers, employees or directors or any affiliated organization responsible for these or other hazards. Because the work will be performed in a back country setting, I understand that emergency medical care may not be readily available. I will follow all directions from FDRD personnel and comply with all applicable rules for volunteers working with this program. In return for my receiving permission from FDRD and any other sponsoring organization to participate in the project, and for other good and valuable consideration, I fully release and indemnify FDRD and all other sponsoring organizations, as well as their respective officers, directors, employees, and agents, from all liability, claims, demands, and causes of action, arising out of damage, loss, or injury to me (including death) or to my property, from whatever cause, as a result of my participation in the project. I intend this Release of Liability to be broadly construed for the benefit of the released parties and to be binding upon my family, heirs, personal representatives, 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, 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 OTHERS DESCRIBED HEREIN, I SIGN IT OF MY OWN FREE WILL.

March 22, 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

Emergency Contact's 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!