volunteer - City of Goshen, Indiana

form

Volunteer Waiver

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Emergency Contact

First Last

Phone

Code of Conduct:

As a City of Goshen volunteer, I agree to:

Exhibit appropriate, courteous behavior at all times.

Show respect to volunteers, staff, participants, equipment, and facilities

Refrain from harassment, foul language, physical harm, alcohol, and illegal drugs

Report any suspicious activity immediately to City personnel

Abstain from political, cultural, and religious pressure

Avoid all interactions with minor children while volunteering unless specifically authorized and in full compliance with the City’s Child Protection Policy

Follow all safety instructions and use required personal protective equipment

Assumption of Risk & Release of Liability:

I, the undersigned volunteer, acknowledge and understand that participation in volunteer activities with the City of Goshen involves certain inherent risks, including but not limited to physical injury, illness, exposure to hazardous materials, property damage, equipment operation, outdoor elements, and unforeseen hazards. These risks may result from my own actions, the actions of others, or the condition of facilities or equipment. I voluntarily assume all such risks associated with my participation, whether known or unknown, and whether caused by the negligence of the Released Parties (as defined below) or otherwise. I fully release, waive, and forever discharge the City of Goshen, its departments, officers, employees, agents, sponsors, affiliates, volunteers, and representatives (collectively, “Released Parties”) from any and all claims, demands, causes of action, costs, expenses, and liabilities for any personal injury, illness, death, property damage, or any other loss sustained as a result of my volunteer activities, except for damages resulting from the gross negligence or willful misconduct of the Released Parties.

Indemnification Agreement:

I agree to indemnify, defend, and hold harmless the Released Parties from and against any claims, liabilities, losses, damages, costs, or expenses (including attorney’s fees and court costs), arising out or related to my volunteer participation. This includes but is not limited to claims brought by third parties alleging injury, damages, or loss caused by my actions or omissions while volunteering. This indemnification obligation applies to any and all claims, whether based on negligence, strict liability, or otherwise, and shall survive my volunteer participation.

Equipment Use & Responsibility:

I acknowledge that any tools or equipment provided to me for volunteer activities are used at my own risk. I agree to operate all equipment safely and in accordance with provided instructions. I further agree to return any borrowed equipment in good condition and assume responsibility for any damages caused due to misuse or negligence.

Medical Consent & Emergency Treatment:

I understand that volunteer activities may result in injury or illness requiring medical attention. In the event of a medical emergency, I authorize City of Goshen personnel or designated representatives to obtain necessary medical treatment on my behalf. I accept full financial responsibility for all medical expenses incurred as a result of such treatment.

Photo & Medial Release:

I grant the City of Goshen permission to capture and use photographs, video recordings, or other media of my participation in volunteer activities for promotional, educational, or other lawful purposes, without compensation of prior approval.

Select one

Yes

Acknowledgement & Agreement:

By signing below, I confirm that I have read, understood, and voluntarily agree to the terms of this agreement. I further acknowledge that I am signing this agreement voluntarily and that I have the legal capacity to do so. I acknowledge that this Agreement is binding upon me and my heirs, executors, administrators, and assigns.

Signature