Volunteer Liability Release Form
hereby acknowledge that I am 18 years of age or older or have completed this application with the permission and assistance of a parent or legal guardian. I understand and agree that submitting this application form does not automatically register me as a Berkeley’s Place volunteer, and that there may be certain qualifications I must meet, including the acceptance of established volunteer policies and procedures before I begin volunteering.
I acknowledge and understand that as a volunteer of Berkeley’s Place, I am not covered by Workers’ Compensation or any other insurance policy through Berkeley’s Place, its partners, members or directors. I fully understand that as part of my volunteer work, I may come into contact with animals. Further, I understand that this carries a risk of injury, and that it is possible that I may be bitten, scratched and/or otherwise injured and I accept risk of injury of working with animals.
I fully understand that as a volunteer I may be lifting animals and other potentially heavy items (e.g. food) and I understand that this may cause bodily injury, strains, fractures or other ailments that could cause serious disability and I accept the risk associated with such work.
I am aware that as a volunteer of Berkeley’s Place, I am acting as a representative of the
organization and agree at all times to act responsibly by maintaining a professional demeanor.
I understand that any and all information provided to Berkeley’s Place is confidential and I will not share any information without the express written approval of Berkeley’s Place. Violation of this policy, including theft of any product, will result in immediate termination of this agreement. I waive all claims to monetary benefits for services rendered as a volunteer worker on a “without compensation basis” for an indefinite period.
I, on behalf of myself, my personal representatives and heirs hereby voluntarily agree to release, waive, discharge, hold harmless, defend and indemnify Berkeley’s Place and its owners, agents, officers or employees from any and all claims, suits or causes of action for including but not limited to medical expenses, lost wages, pain and suffering and disability resulting directly or indirectly from any bodily injury, property damage, wrongful death, loss of services or otherwise which may arise in part or in whole out of any activity that occurs during the performance of my volunteer duties, my interaction with any animals, or my use of any equipment or my participation in any manner whatsoever as a volunteer for Berkeley’s Place.
I specifically understand that I am releasing, discharging and waiving any claims or actions that I may have presently or in the future for the negligent acts or other conduct by Berkeley’s Place and its owners, agents, officers or employees.
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I agree that by submitting this application, I am electronically signing this document.
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