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Last Name:
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Notes:
Liability Release I hereby release and hold harmless United Way of Southwest Louisiana, the agency where I volunteer, and sponsors and supervisors of all activities,from any and all liability for any injury I may suffer (including any injury caused by negligence) in conjunction with the volunteer activity. I also certify that I amin good health and able to participate in the program activities. I certify that I am 18 years of age or older and am competent to contract my name as far as the aboveis concerned. I have read the foregoing release, authorization and agreement, before affixing my initials below and warrant that I fully understand the contentsthereof.*:
Communications Release I hereby waive any claim to the rights of photographic recordings made of me during United Way of Southwest Louisiana's volunteer activity. Ihereby authorize the editing, duplication, reproduction, copyright, exhibition, broadcast and/or non-profit use and distribution of said recordings for purposes deemedsuitable by United Way of Southwest Louisiana. I hereby waive any right to approve the finished products. I certify that I am 18 years of age or older and am competentto contract my own name as far as the above is concerned. I have read the foregoing release, authorization and agreement, by accepting I fully understand the contentsthereof.*:::
I understand that United Way of Southwest Louisiana is a trusted, community organization committed to serving people in need; therefore, I attest that I am notexperiencing any symptoms of illness such as a fever or cough. Furthermore, I aware that I am expected to adhere to the safety and hygiene protocols that havebeenimplemented by United Way of Southwest Louisiana including but not limited to Washing hands frequently with soap and water for at least 20 seconds especiallybeforeand after your volunteer shift, blowing your nose, coughing or sneezing. • If soap and water are not readily available, I agree to use provided handsanitizer thatcontains at least 60% alcohol. • Cover your mouth and nose with a tissue or use the inside of your elbow when you cough or sneeze and to throw usedtissues in thetrash. • Waving to friends or acquaintances rather than hugging or hand shaking.: