Youth Liability Release Form

Habitat for Humanity
RELEASE AND WAIVER OF LIABILITY FOR A MINOR CHILD
The Volunteer and Guardian desire that the Volunteer participate in Habitat’s home building program ("Building Program"), which the Volunteer and Guardian understands consists of constructing residential buildings.
The Volunteer and Guardian freely, voluntarily, and without duress execute this Release under the following terms:
Release and Waiver of Liability (the "Release"), is executed ____________, 2014, by ______________ _____________, a minor child (the "Volunteer"), and _________________________, the parent having legal custody and/or the legal guardian of the Volunteer (the "Guardian"), in favor of Habitat for Humanity of Huron Valley, Inc., a not-for-profit Michigan corporation ("Habitat"), its directors, officers, employees, and agents.
1.
Waiver and Release. Volunteer and Guardian release and hold harmless Habitat, its successors and assigns, from liability, claims, and demands of whatever kind or nature, either in law or in equity, which arise from Volunteer’s participation in the Building Program. By signing this, Volunteer and Guardian discharge Habitat from any liability or claim that Volunteer or Guardian may have with respect to any bodily injury, personal injury, illness, death, or property damage that may result from Volunteer’s participation in The Building Program. Volunteer and Guardian also understand that Habitat does not assume any responsibility for or obligation to provide financial assistance or other assistance, including but not limited to medical, health, or disability insurance.
2.
Medical Treatment and Insurance. Volunteer and Guardian release and forever discharge Habitat from any claim whatsoever which arises now or later on account of any first aid, treatment, or service rendered in connection with the Volunteer’s participation in the Building Program or with any decision by any representative or agent of Habitat to exercise the power to consent to medical or dental treatment as such power may be granted and authorized in the Parental Authorization for Treatment of a Minor Child. Volunteer and Guardian understand that Habitat does not carry or maintain health, medical, or disability insurance coverage for any Volunteer. Each Volunteer is expected and encouraged to have medical or health insurance coverage in effect while participating in the Building Program.
3.
Assumption of the Risk. The Volunteer and Guardian understand that the Building Program may include activities that may be hazardous to the Volunteer. Volunteer and Guardian Assume the risk of injury or harm in these activities and release Habitat from all liability for injury, illness, death, or property damage resulting from the activities of the Volunteer’s participation in the Building Program.
4.
Photographic Release. Volunteer and Guardian grant Habitat all right, title, and interest in photographic images and recordings made by Habitat during the Building Program, including, but not limited to, any royalties, proceeds, or other benefits derived from such photographs or recordings.
5.
Confidentiality. The Volunteer understands and agrees that any personal, confidential and/or proprietary information (the "Confidential Information") learned in the process of volunteering for Habitat is to be considered confidential and proprietary and shall hold the same in confidence, shall not use, disclose, publish or otherwise reveal any Confidential Information except with the specific prior written authorization of the individual disclosing the information.
6.
IN WITNESS WHEREOF, Volunteer and Guardian have executed this Release as of the date above.
Volunteer: Witness:
Sign:_______________________________________________ Sign: ____________________________________
Print:_______________________________________________ Print:_____________________________________
Legal Parent/Guardian Witness:
Sign: _______________________________________________ Sign: _____________________________________
Print: _______________________________________________ Print: _____________________________________
Address: ____________________________________________
City/State: ___________________________________________
Phone: (home) ________________________________________
(office) ________________________________________
Other. This release is intended to be an inclusive as the laws of Michigan permit and that it shall be governed by the laws of Michigan. Volunteer and Guardian agree that if a clause or provision of this release is found by a court to be invalid, that finding shall not invalidate any other clause or provision of this release which shall continue to be enforceable.