Join usHARRISBURG OUTREACH VOLUNTEER FORM Name * First Name Last Name Phone (###) ### #### Email * Select * SELECT A VOLUNTEER POSITION Unloading the truck *For unloading the truck you must be capable of carrying up to 50lb at a time. Distributing food Prayer & sharing the gospel Helping the elderly to collect food Translation (Spanish/English) Volunteer Lifeseeds Volunteer Release and Waiver of Liability Form * By checking this box, I confirm that I have read the above “Lifeseeds Volunteer Release and Waiver of Liability Form.” I express my understanding and intent to enter into this Release and Waiver of Liability willingly and voluntarily. This Release and Waiver of Liability (the “release”) releases LifeSeeds International Inc, (“Nonprofit”), a nonprofit corporation organized and existing under the laws of the Commonwealth of Pennsylvania, its successor and assigns, and any of its directors, officers, employees, agents or representatives. The Volunteer desires to provide volunteer services for Nonprofit and engage in activities related to serving as a volunteer. 1. Waiver and Release: I, the Volunteer, release and forever discharge and hold harmless Nonprofit, its successors and assigns and any of its directors, officers, employees, agents or representatives from any and all liability, claims, and demands of whatever kind of nature, either in law or in equity, which arise or may hereafter arise from the services I provide to Nonprofit. I understand and acknowledge that this Release discharges Nonprofit from any liability or claim that I may have against Nonprofit with respect to bodily injury, personal injury, illness, death, or property damage that may result from the services I provide to Nonprofit or occurring while I am providing volunteer services 2. Insurance: Further I understand that Nonprofit does not assume any responsibility for or obligation to provide me with financial or other assistance, including but not limited to medical, health, or disability benefits or insurance. I expressly waive any such claim for compensation or liability on the part of Nonprofit beyond what may be offered freely by Nonprofit in the event of injury or medical expenses incurred by me. 3. Medical Treatment: I hereby Release and forever discharge Nonprofit from any claim whatsoever which arises or may hereafter arise on account of any first-aid treatment or other medical services rendered in connection with an emergency during my tenure as a volunteer with Nonprofit. 4. Assumption of Risk: I understand that the services I provide to Nonprofit may include activities that may be hazardous to me. As a volunteer, I hereby expressly assume risk of injury or harm from these activities and Release Nonprofit from all liability. 5. Volunteer Relationship: I, the Volunteer, understand that the scope of Volunteer’s relationship with Nonprofit is limited to a volunteer position and that no compensation is expected in return for services provided by Volunteer; that Nonprofit will not provide any benefits traditionally associated with employment to Volunteer; and that Volunteer is responsible for his/her own insurance coverage in the event of personal injury or illness as a result of Volunteer’s services to Nonprofit. I understand and acknowledge that any damage to personal property is not the responsibility of Nonprofit, and that my personal insurance will cover any theft or damage to personal property that occurs while working for Nonprofit. 6. Photographic Release: I grant and convey to Nonprofit all right, title, and interests in any and all photographs, images, video, or audio recordings of me or my likeness or voice made by Nonprofit in connection with my providing volunteer services to Nonprofit. 7. Other: As a volunteer, I expressly agree that this Release is intended to be as broad and inclusive as permitted by the laws of the Commonwealth of Pennsylvania and that this Release shall be governed by and interpreted in accordance with the laws of the Commonwealth of Pennsylvania. I agree that in the event that any clause or provision of this Release is deemed invalid, the enforceability of the remaining provisions of this Release shall not be affected. Date MM DD YYYY Thank you!