Clean Up Event Sign Up Form
Clean Up Event: Ginn Memorial Park
VOLUNTEER RELEASE, WAIVER, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT
I HEREBY ACKNOWLEDGE AND CONFIRM that by participating as a volunteer for the Town of Dumfries in any Town-sponsored activity, or any other volunteer program or related activity created by or involving the Town of Dumfries (hereinafter, “Volunteer Activity” or “Volunteer Activities”), I, the undersigned Volunteer, or the undersigned guardian of a Volunteer, on behalf of myself and any personal representatives, assigns, heirs, or next of kin (hereinafter “Volunteer”), do hereby freely, willfully, and without duress execute this Release, Waiver, Assumption of Risk, and Indemnity Agreement (hereinafter “Agreement”) under the following terms.
- RELEASE AND WAIVER: I hereby release and forever discharge and hold harmless the Town of Dumfries, its elected officials, officers, employees, board members, agents, and their successors and assigns, (hereinafter collectively, “the Town”) from any and all liability, claims, and demands, of whatever kind or nature, either in law or equity, which arise or may hereafter arise from my participation in Volunteer Activities. I understand and acknowledge that the execution of this Agreement discharges the Town from any liability, claim, or demand that I may assert (or my personal representatives, assigns, heirs, or next of kin may assert on my behalf) with respect to any bodily injury, personal injury, illness, death, or property damage which may result from my participation in Volunteer Activities, whether caused by the Town or otherwise. I further understand that the Town assumes no responsibility for and is not obligated in any way to provide financial assistance or other assistance, including but not limited to, medical, health, or disability or liability insurance, in the event of injury, illness, or death. I am aware that as a Volunteer, I am expected to have my own liability and medical insurance which covers me during my participation in all Volunteer Activities.
- INDEMNITY: I agree to indemnify, and hold harmless the Town, its officers and employees from any and all claims and expenses of any nature whatsoever, including the cost of defending such claims, which may accrue against, be charged to, be recovered from or sought to be recovered for the Town, its officials and employees as a result of my participating in Volunteer Activities. I further agree to hold harmless and indemnify the Town from any liability for any property damage or personal injury to any third party that may arise from my participation in Volunteer Activities.
- ASSUMPTION OF RISK: I recognize that Volunteer Activities may involve inherently dangerous or hazardous activities. I am fully aware that there are inherent risks associated with this type of activity, including, but are not limited to, the possibility of bodily injury, physical disability, physical and mental disease, death, and property damage. I am also aware that it is my responsibility to provide the personal safety equipment such as gloves, safety glasses, work boots and similar items needed for my personal safety. I understand the Town is not responsible for supervising or guaranteeing the safety of this program or activity, and I acknowledge that I am responsible for my own safety. I hereby expressly and specifically assume the risk of injury or harm in these situations and release and discharge the Town from and waive any and all liability for any injury, illness, death, or property damage resulting from my participation in Volunteer Activities.
- MEDICAL TREATMENT: I do hereby further release and forever discharge the Town from any claim whatsoever which arises or may hereafter arise on account of any first aid, treatment, or medical service rendered to me that arises from my participation in Volunteer Activities.
- WAIVER OF RIGHTS TO IMAGES: I hereby grant to the Town of Dumfries any and all rights, title, and interest in any and all photographic images and/or video or audio recordings of me made by the Town during my participation in Volunteer Activities, including, but not limited to, royalties, proceeds, or other benefits that may be derived from such photographs or recordings.
- ENTIRE AGREEMENT: I understand this is the complete and only agreement between me and the Town of Dumfries with respect to matters of liability related to my participation in Volunteer Activities, and does not constitute any type of employment relationship between myself and the Town of Dumfries. This Agreement is intended to be as broad and inclusive as permitted by the laws of the Commonwealth of Virginia. If any clause or provision of this Release shall be held to be invalid by any court of competent jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining provisions hereof, which shall continue to be enforceable.
- I have read and understand the foregoing Agreement and agree to the terms of participation as evidenced by the signature(s) below.