Volunteer Application -- Minor : Live By Living

Apply to join our Live By Living volunteer team.

*Your name

*Your email

*Phone

*Date of birth

*Address

*City

*State

*Zip code

*Emergency Contact name

*Emergency Contact phone number

*Where did you hear about us?

*What gender are you?

Male Female I identify differently

*Select the option that best describes your race

How would you like to help?

*Are you of Hispanic or Latino origin?

Yes No

*CONSENT TO USE OF YOUR IMAGE IN PROMOTIONAL MATERIALS

Certifications and Expiration Dates

PARENTAL/GUARDIAN WAIVER OF LIABILITY ON BEHALF OF MINOR

LIABILITY WAIVER:

I am the lawful parent/guardian of the minor child named in this form. I, for myself, my minor child/ward, my heirs, successors, executors and subrogors, hereby KNOWINGLY AND INTENTIONALLY WAIVE AND RELEASE, INDEMNIFY AND HOLD HARMLESS THE LIVE BY LIVING FOUNDATION, its directors, officers, agents, employees, and volunteers from and against any and all claims, actions, causes of action, liabilities, suits, expenses (including reasonable attorneys’ fees) and ORDINARY NEGLIGENCE OF ANY KIND OR NATURE, whether foreseen or unforeseen, arising directly or indirectly out of any damage, loss, injury, paralysis, or death to me or my property as a result of my participating in the Live By Living Foundation outings, whether such damage, loss, injury, paralysis, or death results from ORDINARY NEGLIGENCE of the Live By Living Foundation or any of its directors, officers, agents, employees and volunteers or from some other cause. I, as the lawful parent/guardian of the minor child named in this form, understand and acknowledge that participation in LBL activities includes possible exposure to and illness from infectious diseases including but not limited to COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist. On behalf of my child/ward, I knowingly and freely assume all such risks related to illness and infectious diseases, such as COVID-19, even if arising from the negligence or fault of Live By Living. I, for myself, my child/ward, my heirs, my successors, executors and subrogors, further agree not to sue the Live By Living Foundation as a result of any injury, paralysis or death suffered in connection with my participation in the Live By Living Foundation outings. This release is intended to be a comprehensive release of liability but is not intended to assert defenses which are prohibited by law.

I HAVE CAREFULLY READ, CLEARLY UNDERSTAND AND VOLUNTARILY SIGN THIS USE, WAIVER AND RELEASE AGREEMENT. I CERTIFY THAT I AM THE PARENT OR LEGAL GUARDIAN OF THE MINOR PERSON NAMED IN THIS FORM AS THE VOLUNTEER APPLICANT, AND I AM AUTHORIZED TO SIGN THIS DOCUMENT ON BEHALF OF SAID MINOR.

*SIGNATURE OF PARENT OR AUTHORIZED GUARDIAN

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