This form must be signed by or on
behalf of each volunteer who will participate in or otherwise be involved with
the construction of the Rebuild Texas Fund, YMCA of the Golden Crescent and KaBOOM! Playground Build (the
“Playground Build” or the “Project”), or will be on the construction site of
the Playground Build, occurring on February 16, 2019 in Port Lavaca, TX.
If you are unable to read this print, please speak with the person handling
volunteer registration for assistance.
The KaBOOM! project and activities will include the playground construction,
side projects and play enhancement projects on and in the periphery of the
playground construction site including, without limitation, building interiors
at or near the site. The "playground construction site" is the
physical space where the playground is being installed; the playground
construction projects are any activities directly related to the installation
and placement of the playground equipment, the mixing of concrete, and/or
moving safety surfacing onto the playground site.
Volunteers under age 18 may not work on the "playground construction
site", as defined above. Volunteers under 18 but who meet the
Texas minimum age for employment may work on the side projects, such as
beautification and play enhancement projects, and other non-playground
construction site projects and may help with preparation for the build day only
if they have received and delivered KaBOOM! written approval from a parent or
legal guardian for participation. Any children under the Texas minimum
age for employment will not be supervised by KaBOOM! in any way or be allowed
to participate in playground or non-playground construction projects managed by
KaBOOM!; however KaBOOM! will work with the community partner to procure
supplies for use by these children and to help them plan projects that are
occurring on a site that is distinctly separated from the playground
construction site. No children under the Texas legal working age
should be on the playground construction site.
I understand that I will be
spending the day(s) as a volunteer for the Project and will be participating at
my own risk. I acknowledge that my participation is voluntary and
does not constitute a condition or requirement of employment. I
further acknowledge that the Project will occur at a construction site and that
the construction site will be a potentially dangerous place. I
attest that I am physically fit and prepared for this event and these
activities.
I will not create an unsafe situation for other individuals or myself nor will
I use any tool or engage in any task with which I am not completely
comfortable. I will abide by all applicable federal, state and local
laws, as well as the rules and directions of the sponsors and coordinators. If
I see any situation that I feel is unsafe, I will immediately call it to the
attention of KaBOOM! or a safety coordinator. If I bring any
children or young adults with me to participate in the Project, I will be
solely responsible for providing for their safety and will keep them under
close supervision at all times. FOR EACH PARTICIPANT UNDER 18, THE
PARENT OR GUARDIAN MUST FILL OUT A SEPARATE WAIVER. I understand
that a volunteer may be at the Project to provide medical treatment in the
event of an injury, and if necessary to assist in arranging transportation to
medical facilities, but acknowledge that neither KaBOOM! nor any other of the
Released Parties (as defined below) are in any way responsible for providing
such medical volunteer or treatment.
On behalf of myself, as well as my
heirs, executors, administrators and assigns, I hereby forever release,
discharge, waive and agree to indemnify and hold harmless KaBOOM!, the OneStar
Foundation, the Michael & Susan Dell Foundation, the Rebuild Texas
Fund, YMCA of the Golden Crescent, Landscape Structures Inc., and any additional sponsors of the Project,
along with their respective officers, directors, agents, employees,
contractors, successors and assigns, and any volunteers, including, without
limitation, those to whom I give my consent to provide medical treatment to me
or to any children or young adults under my supervision ("Released
Parties"), from and against any and all claims, demands, actions, causes
of action, obligations, liabilities, suits, losses, damages, costs, expenses,
and fees, including, without limitation, court costs and attorneys’ fees, of
any and every nature of character, including, without limitation, for death,
personal injury and/or loss of property, whether anticipated or unanticipated,
directly or indirectly, whether caused, in whole or in part, by the sole or
concurrent negligence or wrongdoings, strict liability or fault of the Released
Parties or otherwise, arising out of or connected in any way with my
participation in the Project or any side projects in connection with the
Project, including travel to and from the Project.
I represent that I have sufficient
insurance (health, auto, life, etc.) or sufficient financial/other resources to
cover any losses I may incur as a result from participating in the
Project. I acknowledge that I have read the foregoing paragraph and know
and understand the full contents and effects of it.
I hereby grant KaBOOM!, the
OneStar Foundation, the Michael & Susan Dell Foundation, the Rebuild Texas
Fund, and the YMCA of the Golden Crescent full
and complete ownership and permission to use my name and likeness, including
any photographs, videography and interview footage and quotations from me
obtained in connection with the Project (whether or not at the Project Build or
otherwise) in legitimate promotions of the Project and/or to further the
mission and vision of KaBOOM!, the OneStar Foundation, the Michael & Susan
Dell Foundation, and the Rebuild Texas Fund, in any and all media now known or
hereinafter developed, even if there are typographical errors, distortions or
other alterations, without restriction or compensation.
I
understand that I have given up substantial rights by signing this Waiver and
have signed it freely and voluntarily without any inducement, assurance or
guarantee being made to me and I INTEND MY SIGNATURE TO BE A COMPLETE AND
UNCONDITIONAL RELEASE of all liability of Released Parties to the greatest
extent allowed by law.