Sign Up To Volunteer

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Volunteer Information

Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

Date Of Birth

Volunteer is less than 18 years of age*

Yes

Volunteer Preferences

Interested Volunteer Areas

Check all that apply.

Home Team

Garden/Landscaping

Social Services

Drivers

Medical Team

Community Store Procurement

Parent/Guardian Information

PLEASE READ CAREFULLY! THIS IS A LEGAL DOCUMENT THAT AFFECTS YOUR LEGAL RIGHTS! IMPORTANT: If the Volunteer is less than 18 years of age, all parents or guardians must also sign this Release and Waiver of Liability. If only one parent or guardian executes this Release on behalf of a Volunteer who is under 18 years of age, then the undersigned parent or guardian of the Volunteer hereby covenants, warrants, represents and agrees that he or she is executing this Release on behalf of, and as an agent for, any other individual who may be a parent or guardian of the Volunteer, and that by executing this Release, the undersigned is binding himself/herself, the Volunteer, and any other parent or guardian of the Volunteer, and all of their heirs, executors, personal representatives, assigns and estates to this Release.

Parent/Guardian Name*

First Last

Parent/Guardian Address*

Street Address Address Line 2 City State ZIP Code

Parent/Guardian Signature*

Parent/Guardian 2 Name

First Last

Parent/Guardian 2 Address

Street Address Address Line 2 City State ZIP Code

Parent/Guardian 2 Signature

Emergency Contact

Emergency Contact Name*

First Last

Relationship*

Emergency Contact Phone*

Release and Waiver of Liability

Consent*

I agree to the release and waiver of liability

I, the Volunteer, execute this Release and Waiver of Liability (this “Release”) in favor of Eden Village of Kansas City and their respective directors, officers, trustees, employees, volunteers and agents (collectively, the “Released Parties”).

I, the Volunteer, desire to work as a volunteer for one or more of the Released Parties and engage in the activities related to being a volunteer (“Activities”). I understand that my Activities may include but are not limited to the following: working in administrative offices; traveling to and
from work sites, cities, or counties; consuming provided food; living in housing provided for volunteers; constructing and rehabilitating residential buildings; and other construction-related activities.

I, the Volunteer, hereby freely, voluntarily and without duress execute this Release under the following terms:

Release and Waiver

I, the Volunteer, do hereby release and forever discharge and hold harmless the Released Parties and their successors and assigns from any and all liability, claims and demands which I or my heirs, assigns, next of kin or legal representatives may have or which may hereinafter accrue with respect to any bodily injury, personal injury, illness, death or property damage which arise or may hereafter arise from or is in any way related to my Activities with any of the Released Parties, whether caused wholly or in part by the simple negligence, fault or other misconduct, other than intentional or grossly negligent conduct, of any of the Released Parties or of other volunteers.

I understand and acknowledge that by this Release I knowingly assume the risk of injury, harm and loss associated with the Activities. I also understand that the Released Parties do not assume any responsibility for or obligation to provide financial assistance or other assistance, including but not limited to medical, health or disability insurance in the event of injury, illness, death or property damage.

It is the policy of Eden Village of Kansas City that children under the age of 14 are not allowed on Eden Village of Kansas City worksites while construction is in progress. Minors aged 14-15 are only allowed on groundbreaking, painting, or landscaping sites. Minors aged 16-17 may be allowed to participate in construction work, but are prohibited from various activities: use of power tools, excavation, demolition, working six feet above the ground or on rooftops.

Medical Treatment:

I, the Volunteer, do hereby release and forever discharge the Released Parties from any claim or action whatsoever which arises or may hereafter arise 2 on account of any first aid, treatment or service rendered in connection with my Activities with any of the Released Parties.

If the Volunteer is less than 18 years of age, the Volunteer and the parents having legal custody and/or the legal guardians of the Volunteer (the “Guardians”) also hereby release and forever discharge the Released Parties from any claim whatsoever which arises or may hereafter arise on account of the decision by any representative or agent of the Released Parties to exercise the power to consent to medical or dental treatment.

Assumption of the Risk:

I, the Volunteer, understand that my Activities may include work that may be hazardous to me, including, but not limited to, the following: construction; loading and unloading; travel to and from the work sites; and exposure to lead, asbestos, and mold, which may cause or worsen certain illnesses, especially if I do not wear protective equipment, am exposed for extended periods of time, or have a pre-existing immune system deficiency.

I hereby expressly and specifically assume the risk of injury or harm in the Activities and release the Released Parties from all liability for any loss, cost, expense, injury, illness, death or property damage resulting directly or indirectly from the Activities.

Sex Offender and Criminal Background Check Policy:

I, the Volunteer, understand that Eden Village of Kansas City reserves the right to request criminal background and sex offender checks at any point during Volunteer Activities. All checks will be kept confidential. It is the policy of Eden Village of Kansas City that criminal background checks be conducted for all potential partner families, board members, employees, and key volunteers. “Key volunteers” generally refers to individuals who work eight or more hours each month and/or have contact with vulnerable populations such as children, the elderly or persons with disabilities.

Insurance:

I, the Volunteer, understand that, except as otherwise agreed to by the Released Parties in writing, the Released Parties are under no obligation to provide, carry or maintain health, medical, travel, disability or other insurance coverage for any Volunteer. Each Volunteer is expected and encouraged to obtain his or her own health, medical, travel, disability or other insurance coverage.

Policy Against Proscribed Harassment and Discrimination:

I, the Volunteer, understand that Eden Village of Kansas City will not tolerate harassment relating to any characteristic protected under applicable law by any employee, contractor, vendor, customer, or volunteer. Protected characteristics include age, race, color, national origin, pregnancy, gender, gender identity or expression, sexual orientation, religion, physical or mental disability, medical condition, genetic information, marital status, veteran 3 status, military status, or any other characteristic protected by federal, state, or local law. Please report any incident of harassment or discrimination to info@edenvillagekc.org.

Photographic Release:

I, the Volunteer, do hereby grant and convey unto Eden Village of Kansas City all right, title and interest in any and all photographs and video or audio recordings of or including my image or voice, made by any of the Released Parties during my Activities with the Released Parties, including, but not limited to, the right to use such photographs or recordings for any purpose and to any royalties, proceeds or other benefits derived from them.

COVID-19:

I, the Volunteer, acknowledge and understand that in connection with the COVID-19 coronavirus pandemic (including related diseases “COVID-19”), the Released Parties cannot guaranty that I will not become exposed to or infected with COVID-19, despite reasonable efforts to mitigate such dangers. I acknowledge and understand that participating in the Activities could increase my risk of contracting COVID-19 and related consequences, which are well publicized. I acknowledge that my participation is completely voluntary.

I agree that I will not visit Eden Village of Kansas City premises if I believe I have COVID19 at the time of visiting Eden Village of Kansas City premises. For purposes of this Release “premises” includes any premises owned or leased by Eden Village of Kansas City. I also will not visit any Eden Village of Kansas City premises if I have known exposure to anyone who has COVID-19 (or is known to me to be waiting on test results) or if I have traveled internationally at any time during the 14-day period prior to visiting Eden Village of Kansas City premises. Finally, I also will not visit Eden Village of Kansas City premises if I have symptoms of COVD-19, including any of the following (a) a fever, (b) a new loss of taste or smell or (c) any combination of two or more or the following symptoms:

Cough

Shortness of breath or difficulty breathing

Fatigue

Muscle or body aches

Headache

New loss of taste or smell

Sore throat

Congestion or runny nose

Nausea or vomiting

Diarrhea

I acknowledge that it is my responsibility to (a) maintain appropriate social distancing and hygiene (before, during and after using Eden Village of Kansas City premises), (b) report any COVID-19 symptoms or other illnesses to a Key volunteer, (c) maintain contact tracing with respect to any suspected exposure, and (d) immediately withdraw from participation in any Activities if I experience the above symptoms or other illness and promptly report such occurrence.

Other:

I, the Volunteer, expressly agree that this Release is intended to be as broad and inclusive as permitted by the laws of the state where the Activities take place. I further agree that in the event 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 clauses or provisions of this Release, which shall continue to be enforceable. Further, a waiver of a right under this Release does not prevent the exercise of any other right. To express my understanding of this agreement with this Release, I sign here with a witness.

Electronic Signature*

If the volunteer is a minor, this must be signed by a parent/legal guardian. I agree and understand that by signing the Electronic Signature Acknowledgment and Consent Form, that all electronic signatures are the legal equivalent of my manual/handwritten signature and I consent to be legally bound to this agreement.