Document Type:
Exhibit Number: 2.01q
Effective: 10-01-09
Revised: 12-15-09
Legal References:
INDIVIDUAL VOLUNTEER WAIVER
Name of Volunteer:
Email Address:
Address:
City:
State:
Zip:
Home Phone:
Work/Mobile Phone:
Emergency Contact (Print Name):
Address:
Phone:
AGREEMENT BY VOLUNTEER:
I agree to volunteer my services to the City of Boise in accordance with the following understandings:
1. I will offer my services with no expectation of pay, benefits or other privileges of employment of any kind. I certify that I have not been promised and have no expectation that I will receive a paid position as a result of my volunteer work.
2. I understand that placement into volunteer positions are at the sole discretion of the City of Boise. Accordingly, my volunteer assignment/service may be withdrawn or terminated at any time.
3. My volunteer service will not confer on me the status of a City employee, while acting within the scope of this Agreement.
4. I certify that I have been given and have read the City of Boise Volunteer Handbook. I understand my job duties and the potential hazards/risks that are involved, if any, for this volunteer position. I understand it is my responsibility to be aware of my physical condition and I will not engage in physical activities that are beyond my capabilities. I will notify my volunteer coordinator/supervisor of any significant change in my ability to do the work. If special skills are required for this project, I acknowledge I have been appropriately informed of the required tasks.
5. I grant the City permission to use my image in any and all publicity, advertising, and other materials, including websites and other electronic forms, or any other uses the City may deem proper. I waive any right to payment, royalties or any other consideration for use of the image in perpetuity.
6. I hereby hold harmless and release and forever discharge the City of Boise, its officers, agents, employees and volunteers from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have which arises out of or is in any way connected with this agreement.
7. If I drive a personal vehicle to and from a volunteer project, I certify that the vehicles are properly insured as required by Idaho State Law.
8. I understand and agree that the City is not responsible for any of my personal property that is lost, damaged or stolen while I am participating as a volunteer.
9. If the volunteer is under 18 years of age, a parent/guardian or supervising adult must sign this Agreement.
Volunteer Signature/Date
Parent/Guardian Signature (Required if under 18)/Date
Parent/Guardian Printed Name
Relationship to Volunteer