Global Youth Service Day Liability Waiver

LIABILITY WAIVER

I acknowledge that my participation is completely voluntary on my part and is being undertaken without promise or expectation of compensation. I hereby release and discharge the Youth Services Bureau of Monroe County/Monroe County Government, Monroe County Public Library, Boys and Girls Club of Bloomington, and the City of Bloomington, Indiana, its affiliates, associates, directors, and agents and any participating organizations, for any claims for damages or injury I may incur resulting from my participation in this voluntary community service event. I understand that my participation involves risk of injury and that illness may result directly or indirectly from my participation. I further state that I am in proper condition for participating in these events.

PHOTO RELEASE (You may REFUSE CONSENT and OPT OUT of the photo release when submitting your waiver)

I give my permission to the Youth Services Bureau of Monroe County/Monroe County Government, Monroe County Public Library, Boys and Girls Club of Bloomington, and the City of Bloomington, Indiana, to reproduce any photographs or video taken during this project. I understand that this material may be used in various publications, recruitment materials or for other related endeavors. This material may also appear on the Monroe County Youth Council, Youth Services Bureau of Monroe County/Monroe County Government, Monroe County Public Library, Boys and Girls Club of Bloomington, and the City of Bloomington, Indiana websites. I realize that I will receive no financial compensation for the use of this material.

VOLUNTEER RELEASE HOLD-HARMLESS AND INDEMNIFICATION AGREEMENT (for youth age 17 or under)

I am the parent/legal guardian of the child named below. I recognize that because of the inherent hazards of this activity, my child may sustain some injury. In the event that my child is injured and my spouse or I cannot be contacted, I give my permission to the attending physician to render such treatment as would be normal, and agree to pay the usual charge for such treatment.

I now release the Youth Services Bureau of Monroe County/Monroe County Government, Monroe County Public Library, Boys and Girls Club of Bloomington, and the City of Bloomington, Indiana, its Volunteer Network program, and its employees, agents and assigns for any and all claims for personal injury and/or property damage that may arise from, or be in any way connected to, my child's participation in this activity. I understand that this release applies to both present and future injuries, and that it binds myself, my spouse, my child, and the heirs, executors and administrators of each of these persons. I have read this release and understand all of its terms. I sign it voluntarily and with full knowledge of its significance.

TRANSPORTATION RELEASE HOLD-HARMLESS AND INDEMNIFICATION AGREEMENT (for youth age 17 or under)

In consideration for permission for my child to ride along in a Youth Services Bureau of Monroe County/Monroe County Government, Monroe County Public Library, or City of Bloomington vehicle, for my child's benefit only, I agree to the following:

  1.  To release, hold harmless and indemnify the Youth Services Bureau of Monroe County/Monroe County Government, Monroe County Public Library, Boys and Girls Club of Bloomington, and the City of Bloomington, Indiana, its employees, officers, and agents, for any claim or claims which might arise out of any incident connected with or in any way related to riding in an Youth Services Bureau of Monroe County/Monroe County Government, Monroe County Public Library, Boys and Girls Club of Bloomington, or the City of Bloomington vehicle. This includes claims for personal injury, property damage, and/or other types of harm or injury.
     

  2. To release, hold harmless and indemnify the Youth Services Bureau of Monroe County/Monroe County Government, Monroe County Public Library, Boys and Girls Club of Bloomington, and the City of Bloomington, its employees, officers, and agents, for any claim or claims arising out of any incident connected with or in any way related to riding in a vehicle which may be made or asserted by any other person(s) against the Youth Services Bureau of Monroe County/Monroe County Government, Monroe County Public Library, Boys and Girls Club of Bloomington, or the City of Bloomington. This includes claims for personal injury, property damage, Workers Compensation and/or any other type of harm or injury.

I understand this release binds my child, myself, my spouse, and all heirs, executors and administrators of those individuals. I have read this release and understand all of its terms. I sign it voluntarily and with full knowledge of its significance.

Purpose of Ride Along: Responsibilities related to position.

©2019 by Monroe County Youth Council.

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