Volunteer Information Form
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Email *
Full Name *
Address( Street, City, and ZipCode) *
Mobile Number *
How many hours in a week are you available for volunteering *
Your Interest in Volunteering *
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HIPAA CONSET

MANCA GOLDEN CLUB VOLUNTEER LIABILITY WAIVER FORM  

In return for being allowed to participate in MANCA GOLDEN CLUB volunteer activities and all related activities, including any activities incidental to such participation (“Volunteer Activities”), the undersigned volunteer or Parent/Legal Guardian of Volunteer if volunteer s under age 18 releases and agrees not to sue the MANCA or its officers, Directors, sub-contractors, sponsors, agents and  affiliates from all present and future claims that may be made by me, my family, estates, heirs, or assigns for property damage, personal injury, or wrongful death arising as a result of my participation in the Volunteer Activities, whenever, or however the same may occur.  

I understand and agree that the MANCA GOLDEN CLUB is not responsible for any injury or property damage arising out of the Volunteer Activities, even if caused by their ordinary negligence or otherwise.  

I understand that participation in Volunteer Activities involves certain risks, including, but not limited to, serious injury and death. I am voluntarily participating in the Volunteer Activities with knowledge of the danger involved and I agree to accept all risks of participation.  

I also agree and understand that I need to carry Auto insurance with unrelated passengers, if I intend to give transportation to clients in my car.  

I also understand that I need to verify the auto insurance and registration of the client Automobile before I offer to give them ride in their vehicle.  

I also agree to indemnify and hold harmless the MANCAand MANCA GOLDEN CLUB for all claims arising out of my participation in the Volunteer Activities. 

I understand that this document is intended to be as broad and inclusive as permitted by the laws of the state in which the Volunteer Activities take place and agree that if any portion of this Agreement is invalid, the remainder will continue in full legal force and effect.  

I also acknowledge that the MANCA has not arranged and does not carry any insurance of any kind for my benefit or that of Volunteer (if Volunteer is under 18), my parents, guardians, trustees, heirs, executors, administrators, successors, and assigns.  

I represent that, to my knowledge, I am in good health and suffer no physical impairment that would or should prevent my participation in Volunteer Activities.  

I also understand that this document is a contract that grants certain rights to and eliminates the liability of MANCA and MANCA GOLDEN CLUB. 

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