Date of Birth
Address line 2
State / Province / Region
Zip / Postal code
Skills / Qualifications
Physical / Medical Limitations
Terms and Conditions
In agreeing to this liability waiver, I certify that I am a willing participant in the United Way of Greater Newark (UWGN) volunteer program. I agree to work according to instructions I receive. I agree to behave in a responsible manner. I agree to perform only work that I feel comfortable in doing and that I feel I can accomplish safely.
Permission – Use of Photographs
I grant permission to use individual and group volunteer photographs, films and videos of me for promotional or other uses furthering the mission of the UWGN, including use on the UWGN website.
Acknowledgement and Assumption of Risk
I recognize that the opportunity to participate in the UWGN volunteer program may involve physical labor and may carry a risk of personal injury and I hereby agree to assume all risks which may be associated with my participation.
I hereby release, discharge, waive and relinquish all claims, liabilities and damages I may sustain from bodily injury, personal injury or property damage and hold harmless the UWGN, its officers, directors, employees and agents.
By checking this box, I acknowledge that I have read this form and fully understand that by signing this form I am giving up legal rights and/or remedies which may otherwise be available to me regarding any losses I may sustain as a result of my participation.