In case of an emergency while volunteering, please list someone we may call on your behalf.
Please indicate your approximate days and hours of availability.
WAIVER, RELEASE, HOLD HARMLESS AND
I, understand and agree that, while providing services as a volunteer ("Services") to The Place of Forsyth County, there are certain risks (some of which I may not fully recognize) and that injuries , property damage or other harm could occur to me during or resulting from the provision of the Services, including injuries incurred as a result of lifting heavy objects. I, therefore, covenant and agree, on behalf of myself and my heirs, assigns, and any other person claiming by, under or through me, as follows:
1. I accept and voluntarily incur all risks of any injuries, damages or harm which arise during or result from my provision of the Services, whether or not caused in whole or in part by the negligence or other fault of The Place of Forsyth or its directors, officers, employees, agents or insurers (the "Released Parties").
2. I waive all claims against and hold harmless any and all of the Released Parties for any injuries, damages, expenses, liabilities, losses or claims, whether known or unknown, which arising during or result from my provision of the Services, whether or not caused in whole or in part by the negligence or other fault of any of the Released Parties, and forever release and discharge the Released Parties from all such claims.
3. I understand that confidentiality concerning information pertaining to The Place of Forsyth and its clients is important and agree to maintain as confidential information or knowledge gained through my volunteer Services. Generally speaking, all information that is not publicly available or in the public domain is considered "confidential." I agree to maintain such confidentiality while working as a volunteer at The Place of Forsyth and thereafter. I further understand that my violation of this confidentiality provision could result in immediate release.
4. It is my express intent that this Waiver, Release, Hold Harmless and Confidentiality Agreement ("Agreement") shall bind my successors, assigns, heirs, and personal representative.
5. I acknowledge and agree that this Agreement will be construed in accordance with the laws of the State of Georgia.
6. By signing below, I acknowledge and represent that I have read and understand all of the foregoing, have been advised that I should consult with my own legal counsel prior to signing this Agreement, hereby execute this Agreement voluntarily, as my own free act and deed and that no oral representations, statements or inducements have been made by any of the Released Parties in connection with this Agreement.