Volunteer Broward

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We require date of birth for verification of eligibility with affiliate projects/activities and for demographic reporting for funders.

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Gender

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Marital Status

How did you hear about us?

	Radio			Television
	Newspaper			School
	Corporation			Volunteer Florida
	Children's Services Council			VB Website
	Starbucks			VB volunteer
	Social Networking website			HandsOn Network
	usaservice.org

Availability

	Weekdays (Monday - Friday)
	Weeknights (Monday - Friday)
	Weekends (Saturday - Sunday)
	Weekdays & Weekends
	Weeknights & Weekends
	All / Anytime
	I am available to work on short notice for important volunteer needs

Terms and Conditions

       I, the undersigned, wish to volunteer my services to various community service organizations and projects through you, Volunteer Broward, a not for profit Florida corporation.  In consideration for allowing me to participate in Volunteer Broward projects, and in consideration of Volunteer Broward locating, arranging, coordinating and/or making available volunteer opportunities, I hereby agree and release Volunteer Broward as follows:

	I acknowledge and agree that the nature of the volunteer services which are typically performed by Volunteer Broward volunteers and which may be performed by me as a Volunteer Broward volunteer, may involve a) physical activity (including without limitation work with heavy tools and materials), b) contact with unidentified and unfamiliar persons, c) travel to and from various unspecified locations, and d) other potential risk of injury.  Notwithstanding the preceding sentence, I willingly and freely agree to volunteer and hereby assume any and all risk in connection with my volunteer efforts or participation, including without limitation risk of any accident or injury to person or property which I may sustain in connection with my participation as a Volunteer Broward volunteer or in any Volunteer Broward related project or activity.  In addition to the foregoing, I will only participate in Volunteer Broward activities and projects that I am physically capable of participation without risk of injury to myself.

       I hereby acknowledge that Volunteer Broward is an organization involved in assisting organizations and associations which may from time to time be involved in child care and related matters.  I hereby confirm, represent and warrant that I have never been convicted of a violent crime, child abuse or neglect, child pornography, child abduction, kidnapping, rape or sexual offense or any other violation of law, nor have I ever been ordered by a court to receive psychiatric or psychological treatment in connection therewith.

       I hereby release Volunteer Broward and its directors, officers, partners, agents, employees, successors, assigns, licensees, sponsors, donors, representatives, guests, and affiliates from, and covenant not to sue for, any and all claims and causes of action, whether known or unknown, arising out of, based upon or relating to my participation as a Volunteer Broward volunteer or in any Volunteer Broward related activity or project, including, without limitations, any negligence of Volunteer Broward, its officers, directors, partners, employees, agents, successors, assigns, licensees, sponsors, donors, representatives, guests, and affiliates.  Furthermore, to the extent I utilize my own vehicle for transportation or other purposes, in connection to a Volunteer Broward project or activity, I hereby represent and warrant that I am, and the vehicle is, fully insured to the extent required by law.

       I hereby agree to indemnify and hold Volunteer Broward, its directors, officers, partners, agents, employees, successors, assigns, licensees, sponsors, donors, representatives, guests, and affiliates harmless against any and all liabilities, claims, actions, damages, losses, judgments, fines, deficiencies, injuries, suits and proceedings at law or in equity, costs, or any other expense, fee or charge of any character or nature through all levels of appeal and any amounts paid in settlement of the forgoing which may be imposed upon, incurred or threatened by or upon Volunteer Broward (or any related part as referenced above) or any of its property in respect to, or arising out of, my participation, as a Volunteer Broward volunteer or in any Volunteer Broward  related project or activity.
       
       I further irrevocably grant to Volunteer Broward, its assigns and successors, my consent and full right to: use my name, photograph, likeness, image, voice and biography in and all media, publications, advertising and publicity, in connection with my participation with Volunteer Broward and any Volunteer Broward related activity or project.
       
       This release shall inure to the benefit of Volunteer Broward and its successors, licensees, agents, employees, affiliates, and assigns.  This release shall be governed by the laws of the State of Florida.

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	AN AFFILIATE OF