ORG - Volunteer Release - Blue Ridge Pride

Legal Name(Required)

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Street Address City State / Province / Region ZIP / Postal Code

Emergency Contact(Required)

First Last

Relationship(Required)

Emergency Contact Phone(Required)

Emergency Contact Email(Required)

Liability Waiver and Release(Required)

On behalf of myself and my estate, I hereby waive any right of recovery and I release the Blue Ridge Pride Center, Inc. (BRPC), their officers, officials, employees, and agents, from liability related to myself, arising from any and all injury to persons and damage to property. Furthermore, I agree and undertake to indemnify, hold harmless and defend BRPC from and against all claims, damages, actions, liability, and expenses. These expenses include attorney’s fees and other professional fees in connection with bodily injury including death, personal injury and/or damage to property arising from or out of my activities and participation in volunteer services associated with BRPC. I further acknowledge and agree that BRPC does not assume any responsibility for my personal property. I will not hold BRPC liable for any loss or damage to same.

I agree to the Liability Waiver and Release

Authorization to Use Photographs and/or Audio-Visual Material(Required)

I authorize BRPC to use, reproduce, and/or publish photographs and/or video that may pertain to me, including my image, likeness and/or voice, without compensation. I understand that this material may be used in various publications, public affairs releases, Internet Web pages, recruitment materials, broadcast public service advertising, or for other related endeavors.

If you prefer not to be photographed, let your event supervisor know. We will make an effort to ensure that you are not photographed. However, our events are generally public. We cannot guarantee that you will not be in a photo.

I consent to use of photographs and audio/visuals

Confidentiality (Not Required of Event Volunteers)

I understand that in the course of my work for BRPC, I may learn something about individuals that is personal and confidential. These individuals include clients, visitors, volunteers, staff, and contractors. Examples of personal information include medical conditions and treatments, finances, living arrangements, employment, sexual orientation, gender identity, and personal contact information. I will not disclose information of a personal nature to any person or for any purpose not authorized by BRPC, without specific consent of the individual to whom such information pertains.
I also understand that, in the course of my service, I may learn certain facts about BRPC that are considered proprietary. Examples include mailing lists, financial reports, strategic plans, fundraising plans, and program documents. I agree not to use or share information that is proprietary to BRPC, except as authorized by BRPC. I further agree not to keep it for personal use.

I agree to abide by BRPC's confidentiality policy

Legal Status

I am Over 18 and Have Signed

My Parent or Guardian Has Signed

Date

Full Name of Signer

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Volunteer Agreement and Release Form