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Waiver for Volunteer Application
Who is this registration for?
Please provide a name and email address for a parent or guardian who can sign for you.
Parent/guardian first name:
Parent/guardian email:
Waiver & Release of Liability
I, the undersigned, hereby knowingly, freely, and voluntarily assume all of the risks associated with participation in the Program, including but not limited to, any risks that arise from negligence or carelessness on the part of the CITY OF DELRAY BEACH, its officers, employees, agents, or volunteers (collectively the CITY). I, for myself, family, guardians, child, children, heirs, executors and administrators, agree to release, waive, discharge, and acquit the CITY of any liability, claim, and cause of action I have ever had, now have, or hereafter can, must, or may have, against the CITY in connection with or arising out of participation in the Program or use of facilities or equipment associated with the Program including but not limited to any claims caused in whole or in part from the negligence of the CITY.
I, for myself, family, guardians, child, children, heirs, executors and administrators, further agree to indemnify and hold the CITY harmless from and against any claim, demand, or cause of action of whatsoever kind or nature including attorney’s fees, costs, and expenses resulting from losses sustained by third parties arising out of participant’s participation in the Program or use of facilities or equipment associated with the Program including but not limited to any claims caused in whole or in part from the negligence of the CITY.
I further acknowledge, understand, and agree that to the best of my knowledge, that participant is in Good Physical Condition and has no disease or injury that would prevent participant from safely participating in the Program.
At various times, the City of Delray Beach videotapes and photographs events/programs that may be submitted to the local media. By participating in the Program, I authorize the CITY to reproduce, copy, exhibit, publish, broadcast, or distribute any and all such tapes or photographs.
(1) The undersigned has read all of the above information and understands that the undersigned is voluntarily giving up certain rights by signing this waiver and release of liability form.
(2) I declare that I have read the foregoing document and agree to the waiver, release, and indemnification of the City as stated.
Under penalty of perjury, I declare that I have read the foregoing document and the facts stated herein are true.
A background check may be required for certain volunteer positions that give access to confidential information and/or for those positions wherein the volunteer will be
working closely with children. This includes the following:
• Employment records/Employers references
• Criminal background records/information
• Sex offender registry check
• Driver’s license check
• Training/experience
• Personal references
• Addresses
• Social Security Verification
I, the undersigned, authorize this information to be obtained either in writing or via telephone in connection with my volunteer application. Any person, firm or organization providing information or records in accordance with this authorization is released from any and all claims of liability for compliance. Such information will be held in confidence in accordance with the organization’s guidelines.
I have read the above, and understand the rules and regulations for the City of Delray Beach Program that have been made available to me.
Waiver & Release of Liability
I, the undersigned, hereby knowingly, freely, and voluntarily assume all of the risks associated with participation in the Program, including but not limited to, any risks that arise from negligence or carelessness on the part of the CITY OF DELRAY BEACH, its officers, employees, agents, or volunteers (collectively the CITY). I, for myself, family, guardians, child, children, heirs, executors and administrators, agree to release, waive, discharge, and acquit the CITY of any liability, claim, and cause of action I have ever had, now have, or hereafter can, must, or may have, against the CITY in connection with or arising out of participation in the Program or use of facilities or equipment associated with the Program including but not limited to any claims caused in whole or in part from the negligence of the CITY.
I, for myself, family, guardians, child, children, heirs, executors and administrators, further agree to indemnify and hold the CITY harmless from and against any claim, demand, or cause of action of whatsoever kind or nature including attorney’s fees, costs, and expenses resulting from losses sustained by third parties arising out of participant’s participation in the Program or use of facilities or equipment associated with the Program including but not limited to any claims caused in whole or in part from the negligence of the CITY.
I further acknowledge, understand, and agree that to the best of my knowledge, that participant is in Good Physical Condition and has no disease or injury that would prevent participant from safely participating in the Program.
At various times, the City of Delray Beach videotapes and photographs events/programs that may be submitted to the local media. By participating in the Program, I authorize the CITY to reproduce, copy, exhibit, publish, broadcast, or distribute any and all such tapes or photographs.
(1) The undersigned has read all of the above information and understands that the undersigned is voluntarily giving up certain rights by signing this waiver and release of liability form.
(2) I declare that I have read the foregoing document and agree to the waiver, release, and indemnification of the City as stated.
Under penalty of perjury, I declare that I have read the foregoing document and the facts stated herein are true.
A background check may be required for certain volunteer positions that give access to confidential information and/or for those positions wherein the volunteer will be
working closely with children. This includes the following:
• Employment records/Employers references
• Criminal background records/information
• Sex offender registry check
• Driver’s license check
• Training/experience
• Personal references
• Addresses
• Social Security Verification
I, the undersigned, authorize this information to be obtained either in writing or via telephone in connection with my volunteer application. Any person, firm or organization providing information or records in accordance with this authorization is released from any and all claims of liability for compliance. Such information will be held in confidence in accordance with the organization’s guidelines.
I have read the above, and understand the rules and regulations for the City of Delray Beach Program that have been made available to me.
Check here to show you accept the terms stated above for yourself.
Parental Consent
Waiver & Release of Liability
I, the undersigned, hereby knowingly, freely, and voluntarily assume all of the risks associated with participation in the Program, including but not limited to, any risks that arise from negligence or carelessness on the part of the CITY OF DELRAY BEACH, its officers, employees, agents, or volunteers (collectively the CITY). I, for myself, family, guardians, child, children, heirs, executors and administrators, agree to release, waive, discharge, and acquit the CITY of any liability, claim, and cause of action I have ever had, now have, or hereafter can, must, or may have, against the CITY in connection with or arising out of participation in the Program or use of facilities or equipment associated with the Program including but not limited to any claims caused in whole or in part from the negligence of the CITY.
I, for myself, family, guardians, child, children, heirs, executors and administrators, further agree to indemnify and hold the CITY harmless from and against any claim, demand, or cause of action of whatsoever kind or nature including attorney’s fees, costs, and expenses resulting from losses sustained by third parties arising out of participant’s participation in the Program or use of facilities or equipment associated with the Program including but not limited to any claims caused in whole or in part from the negligence of the CITY.
I further acknowledge, understand, and agree that to the best of my knowledge, that participant is in Good Physical Condition and has no disease or injury that would prevent participant from safely participating in the Program.
At various times, the City of Delray Beach videotapes and photographs events/programs that may be submitted to the local media. By participating in the Program, I authorize the CITY to reproduce, copy, exhibit, publish, broadcast, or distribute any and all such tapes or photographs.
(1) The undersigned has read all of the above information and understands that the undersigned is voluntarily giving up certain rights by signing this waiver and release of liability form.
(2) I declare that I have read the foregoing document and agree to the waiver, release, and indemnification of the City as stated.
Under penalty of perjury, I declare that I have read the foregoing document and the facts stated herein are true.
A background check may be required for certain volunteer positions that give access to confidential information and/or for those positions wherein the volunteer will be
working closely with children. This includes the following:
• Employment records/Employers references
• Criminal background records/information
• Sex offender registry check
• Driver’s license check
• Training/experience
• Personal references
• Addresses
• Social Security Verification
I, the undersigned, authorize this information to be obtained either in writing or via telephone in connection with my child’s volunteer application. Any person, firm or organization providing information or records in accordance with this authorization is released from any and all claims of liability for compliance. Such information will be
held in confidence in accordance with the organization’s guidelines.
I have read the above, and understand the rules and regulations for the City of Delray Beach Program that have been made available to me.
Check here to show you accept the terms stated above for yourself or for a minor Volunteer for which you are the parental guardian.
