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This Release and Waiver of Liability Form (hereinafter the “Release”) is executed this day of
in favor of SHREVEPORT VOLUNTEER NETWORK INC., a nonprofit corporation organized and existing under the laws of the State of Louisiana, along with its directors, officers, employees, members, agents, affiliates, and volunteers (hereinafter collectively “SNV”).
Waiver and Release of Liability: PROPERTY OWNER, for myself and for my heirs and assigns, hereby waives, releases and agrees to forever indemnify and hold harmless SVN and its affiliates, agents, members, employees, volunteers, officers, directors, successors, and assigns for any and all claims, causes of action, losses, or liabilities of any nature that may arise as a result of my participation in disaster response operations. This includes any and all claims for property damage, illness, bodily injury, personal injury, and/or death, even if such damage, illness, injury, or death is caused by any of the parties’ negligence listed in the preceding sentence. If Volunteer is a minor, the Parent/Guardian who executes below accepts full responsibility for the care and supervision of the minor during these activities.
Further, I acknowledge and understand SVN assumes no responsibility and has no obligation, to provide financial or other assistance including, but not limited to medical, health, or disability insurance in the event of property damage, illness, bodily injury, personal injury, or death.
Assumption of Risk: PROPERTY OWNER, acknowledges that by engaging in disaster response services and activities related to those services, said services and activities may be hazardous and unstable during the clean-up process. I understand those activities may include, but are not limited to, the following sorts of activities; travel to and from disaster areas, proximity to moving parts, cleaning up and exposure to debris from weather-related disasters, working in areas that may be without power, and sanitation, operating and handling dangerous tools and equipment, etc. Property Owner further acknowledges and understands that some situations may involve, and likely will involve inherently dangerous activities. I, for myself and for my heirs and assigns, expressly and specifically assume any and all risks of injury or harm, including death, and release and hold harmless SVN from all liability for property damage, illness, bodily injury, personal injury, and/or death resulting from the activities engaged in while serving as Volunteer with SVN.
Insurance: PROPERTY OWNER, acknowledges that SVN does not maintain, carry or provide property, health, medical, or disability insurance coverage for the property owner or volunteers, and further acknowledges that SVN expressly disclaims responsibility for providing property, health, medical, or disability insurance coverage for the property owner and volunteers assisting in emergency disaster response services and activities related to those services.
Insurance Requirements: SVN EXPECTS AND ENCOURAGES VOLUNTEERS TO CARRY BOTH LIABILITY AND MEDICAL/HEALTH INSURANCE PRIOR TO VOLUNTEERING FOR EMERGENCY DISASTER RESPONSE SERVICES.
Photographic Release: PROPERTY OWNER, grants and conveys unto SVN all right, title, and interest in any and all photographic images and video or audio recordings made by SVN while serving as Volunteer. SVN will have the right to freely reproduce, publish and/or circulate any photographic images and video or audio recordings at their sole discretion. Volunteer acknowledges that Volunteer will not be entitled to any compensation, including, but not limited to any royalties, proceeds, or other benefits derived from such photographs or recordings.
Other: I, as PROPERTY OWNER, acknowledge it is my desire to grant permission to SVN in providing emergency disaster response services and participate in activities related to those services. I further acknowledge and understand that SVN is performing said services as a volunteering opportunity to help those in need during disasters and will be owed no compensation and that, in performing said services.
This Release is being executed as a result of my free and voluntary desire and without any duress. To further acknowledge my understanding of this Release, I have executed this with a witness.
