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I desire to work as a volunteer for Habitat for Humanity Inland Valley (“Habitat for Humanity”) without compensation and engage in the activities related to being a volunteer. I understand that my activities may include: working at Habitat for Humanity offices, worksites, and fundraising events; working for ReStore operations; loading and unloading materials; traveling to and from work sites, and other activities (“Activities”).

Release and Waiver. I acknowledge that participation in the Activities may involve certain risks, including, but not limited to, personal injuries, bodily injury, illness, disability, or property damage. I do hereby release and forever discharge and hold harmless Habitat for Humanity from any and all liability, claims, demands, costs and damages, whether arising from tort, contract or otherwise, which arise from, or are in any way related to my Activities with Habitat for Humanity, whether caused wholly or in part by the simple negligence, fault or other misconduct of Habit for Humanity or volunteers, other than their intentional or grossly negligent conduct. I understand that my Activities may include work that may be hazardous, including, but not limited to, exposure to lead, asbestos and mold. I acknowledge that I knowingly assume the Risks associated with the Activities. I understand that Habitat for Humanity does not assume any responsibility for or obligation to provide financial assistance or other assistance, including but not limited to medical, health or disability insurance in the event of injury, illness, death or property damage. I acknowledge that children under the age of 16 are not allowed on Habitat for Humanity worksites while construction is in progress. While minors between the ages of 14 and 18 may be allowed to participate in some worksite activities, I understand that using power tools, demolition, working on rooftops and similar activities are not permitted for anyone under the age of 18. 

COVID-19. Habitat for Humanity complies with CDC and Riverside County Dept. of Public Health recommendations for health and safety measures related to COVID-19. A risk of exposure to COVID-19 exists in any public place where people are present and by participating in volunteer Activities, I assume all risks related to exposure. I will follow all posted instructions while volunteering.

Consent to Transportation and Medical Treatment. I consent to the use of first aid treatment and the use of generic and over-the-counter medications as directed. In an emergency, I understand Habitat for Humanity may try to contact the individual listed below as an emergency contact. If an emergency contact cannot be reached promptly, I authorize Habitat for Humanity to act as an agent to consent to any examination, testing, x-rays, medical, dental or surgical treatment as advised by a physician or other health care provider. I also authorize Habitat for Humanity to arrange for transportation as deemed necessary. I do hereby release and hold harmless Habitat for Humanity from any liability, claim, demand, and action whatsoever brought by me or on my behalf which arises or may hereafter arise on account of any transportation, first aid, assessment, care, treatment, response or service rendered in connection with my Activities as a volunteer.

I understand that, except as otherwise agreed to in writing, Habitat for Humanity is under no obligation to provide, carry or maintain health, medical, travel, disability or other insurance coverage for any Volunteer. Each Volunteer is expected to obtain their own health, medical, travel, disability or other insurance coverage. I understand that I am responsible for payment of such hospital, physician, ambulance, dental, medical or other services obtained for me or my child. I agree that Habitat for Humanity does not assume any responsibility for the payment fees or expenses which may be incurred.

Photographic/Recording Release. I give my express and unconditional permission and consent to Habitat for Humanity to use videotaped or photographed images of me or said minor or otherwise use the name or my likeness for use in Habitat’s public relations materials. I will not seek any fee or other form of compensation for such use. I hereby give up any rights that I or said minor may have to inspect or approve my images, name or likeness including advertising copy, printed matter, website, or other media or material in which they may appear in relation to Habitat for Humanity publicity or public relations materials.

By signing below, I acknowledge, understand, and have read the above agreement, release from liability, photographic release, and COVID-19 information.

Date: December 21, 2024

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
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Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
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 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.


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