St. Therese Visit Volunteer Form Alt

This release and waiver of Liability (the “Release”) executed today, the date of submission of this form, you (the “Participant”) in favor of the SACRED HEART RETREAT HOUSE, A CALIFORNIA CORPORATION, a non-profit corporation organized and existing under the laws of the State of California, USA, its directors, officers, employees, volunteers and agents (collectively, “The Sacred Heart Retreat House”).

I, the Participant, desire to volunteer with the Sacred Heart Retreat House to provide assistance and engage in the activities related to offering these services. I understand that the activities may include, but are not limited to, travel to and from the Sacred Heart Retreat House, moving and lifting heavy objects; cooking and serving food.

I hereby freely and voluntarily, without duress, execute the Release under the following terms:

1. Waiver and Release. I, the Participant, release and forever discharge and hold harmless the Sacred Heart Retreat House from any claim or liability that I, the Participant, may have against the Sacred Heart Retreat House with respect to any bodily injury, personal injury, illness, death or property damage that may result from my participation in volunteering at the Sacred Heart retreat House. I also understand that the Sacred Heart Retreat House does not assume any responsibility or obligation to provide financial or other assistance, including but not limited to medical, health, or disability insurance, in the event of injury, illness, death or property damage (see insurance information below).


2. Insurance. The Sacred Heart Retreat House does not carry or maintain, and expressly disclaims responsibility for providing any health, medical or disability insurance coverage for the Participant. EACH PARTICIPANT IS EXPECTED AND ENCOURAGED TO CARRY PERSONAL LIABILITY OR HEALTH INSURANCE PRIOR TO REGISTERING AS A SACRED HEART RETREAT HOUSE VOLUNTEER.


3. Medical Treatment. Except as otherwise agreed to by the Sacred Heart Retreat House in writing, I hereby release and forever discharge the Sacred Heart Retreat House from any claim whatsoever which arises or my hereafter arise on account of any first-aid treatment or other medical services rendered in connection with an emergency during my time at the Sacred Heart Retreat House.


4. Assumption of Risk. I understand that my time with the Sacred Heart Retreat House may include activities that may be hazardous to me, including, but not limited to, cooking and food preparation activities, loading and unloading of heavy equipment and materials, transportation to and from the Sacred Heart Retreat House. I recognize and understand that my time at the Sacred Heart Retreat House may, in some situations, involve inherently dangerous activities. I hereby expressly and specifically assume the risk of injury or harm in these activities and release the Sacred Heart Retreat House from all liability for injury, illness, death, or property damage resulting from the activities of my time at the Sacred Heart Retreat House.


5. Photographic Release. I grant and convey unto the Sacred Heart Retreat House all right, title and interest in any and all photographic images and video or audio recordings made by the Sacred Heart Retreat House during my work for the Sacred Heart Retreat House, including, but not limited to, any royalties, proceeds or other benefits derived from such photographs or recordings.


6. Other. I understand that it is my desire to further the work of the Sacred Heart Retreat House by performing services as a Volunteer. I undertake to perform said services as a Volunteer without compensation and that, in performing said services, I acknowledge that I am not acting as an employee of the Sacred Heart Retreat House.

I, the undersigned, request to participate in the Group/Activity/Event noted above.
I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY/ALL ACTIVITIES ASSOCIATED WITH SANTA TERESITA, INC., including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault.
In consideration of permitting me to participate in this volunteer service, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows:
(A) I WAIVE, RELEASE, AND DISCHARGE the Santa Teresita, Inc., its parent, subsidiaries, affiliates, members, or their respective officers, directors, employees volunteers, representatives, agents, activity holders, and sponsors (hereafter known as “RELEASEE”) from any and all claims for personal injuries or property damage that I/he/she may suffer as a result of participation in the program or event listed above, whether or not such injuries or damages are caused by the negligence (active or passive) of the RELEASEE.
(B) I RELEASE AND DISCHARGE the RELEASEE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this activity.
(C) I INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the RELEASEE from any and all liabilities or claims made as a result of participation in this activity, whether caused by the negligence of release or otherwise.
I acknowledge that the RELEASEE is NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific activity on their behalf.
I acknowledge that this volunteer service may involve a test of a person's physical and mental limits and carries with it the potential for death, serious injury, and property loss. The risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, lack of hydration, and actions of other people including, but not limited to, participants, volunteers, monitors, and/or producers of the activity. These risks are not only inherent to participants, but are also present for volunteers.
I certify that I am physically fit and have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems which preclude my participation in this volunteer service.
I acknowledge that this Accident Waiver and Release of Liability Form will be used by the event holders, sponsors, and organizers of the activity in which I may participate, and will govern my actions and responsibilities at said activity.
I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during this activity. I hereby give the RELEASEE permission to use their judgment in obtaining medical service, and I give permission to the physician selected by the RELEASEE personnel to render medical treatment deemed necessary and appropriate by the physician. I agree to relieve the RELEASEE and other participating adults from any liability in connection with this request. I agree to assume financial responsibility for all expenses of such care.
The Accident Waiver and Release of Liability Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.