BROOKLINE FOOD PANTRY General Release and Waiver by Volunteer
This Release & Waiver of Liability (the “Release”) is executed on this ____ day of ____________, 20____, by_________________________________ (the “Volunteer”) or (the “Parent or Guardian of Volunteer”) in favor of THE BROOKLINE FOOD PANTRY, INC., d/b/a THE BROOKLINE FOOD PANTRY, and f/k/a THE BROOKLINE EMERGENCY FOOD PANTRY, a nonprofit corporation organized and existing under the laws of the Commonwealth of Massachusetts, its directors, officers, employees, agents, representatives, heirs, attorneys, successors and assigns (collectively, the“BFP”).
I, the Volunteer, hereby desire to work as a volunteer for the BFP and to engage in the activities related to being a volunteer for the BFP. As such, I hereby freely and voluntarily, without duress, execute this Release under the following terms:
1. WAIVER & RELEASE. I, the undersigned Volunteer, release and forever discharge and hold harmless BFP
and its officers, directors, partners, members, employees, agents, representatives, attorneys, heirs, successors and assigns (the “Releasees”), from any and all liability, claims, and/or demands of whatever kind or nature, either in law or in equity, which arise, have arisen or may hereafter arise from my volunteer work with BFP. I understand and acknowledge that this Release discharges BFP from any liability or claim that I, the undersigned Volunteer, may have now or in the future against BFP with respect to bodily injury, personal injury, illness, death, or property damage that may result or arise from or be in any way connected with my participation in the events and volunteer activities for the BFP including, without limitation, those caused by the negligent acts or omissions of the Releasees. I also understand that the BFP does not assume any responsibility for or obligation to provide financial assistance or other assistance, including but not limited to medical, health, worker’s compensation, or disability insurance, in the event of injury, illness, death or property damage.
2. INSURANCE. The BFP does not carry or maintain, and expressly disclaims responsibility for providing any health, medical, worker’s compensation, or disability insurance coverage for the undersigned Volunteer. BFP may have commercial general liability insurance which may or may not apply to specific circumstances. EACH VOLUNTEER IS EXPECTED AND ENCOURAGED TO ARRIVE WITH MEDICAL OR HEALTH INSURANCE COVERAGE IN EFFECT.
3. MEDICAL TREATMENT. I, the undersigned Volunteer, hereby release and forever discharge BFP from any claim or claims whatsoever which may have arisen, arise or may hereafter arise on account of any first aid treatment or other medical services rendered in connection with an emergency during my time with BFP.
4. ASSUMPTION OF RISK. I, the undersigned Volunteer, understand that my work with the BFP may include activities that may be hazardous to me, including, but not limited to, loading and unloading of food and transportation. I hereby expressly and specifically assume the risk of injury or harm in these activities and release the BFP from all liability for injury, illness, death, or property damage resulting from the activities of my work with the BFP.
5. INDEMNITY. I, the undersigned Volunteer, agree that if any claim for my personal injury or wrongful death is commenced against BFP, I shall defend, indemnify and save harmless the BFP from any and all claims or causes of action by whomever or wherever made or presented for my personal injuries, property damage or wrongful death.
6. USE OF VEHICLE. To the extent my automobile is used for the transportation of customers of the BFP and/
or food or other goods to be used for or by the BFP, or to the extent I volunteer to drive the vehicle of another in connection with my work as Volunteer, I, the undersigned Volunteer, represent that I am in possession of a current state driving license, and have the appropriate registration and insurance, proof of which shall be provided upon the BFP’s requests. As a volunteer, I undersigned that my safety and the safety of others is paramount. I understand that driving as a volunteer is a privilege, not a right, and therefore, I agree to:
Provide evidence of my current status as a licensed driver in Massachusetts.
Comply with all of the BFP’s policies and procedures and any directions provided by the BFP;
Comply with all laws and regulations concerning driving, including laws pertaining to the use of seat belts, child safety seats, cell phone use, and speed limits;
Promptly notify the BFP of any physical conditions, vehicle defects, or road conditions that might affect my safety or the safety of those I am driving;
Notify the BFP of any traffic citations I receive—even if given while driving on my personal time;
If involved in an accident, I agree to complete an Accident Report provided by Police and/or insurance company and to cooperate with the police, the BFP, and the BFP’s insurer, its insurance adjusters and/or attorneys.
I pledge that if I drive my own vehicle on behalf of BFP, adequate insurance will always be in force;
I also understand that as a volunteer driver, the limits and coverages provided by my personal automobile insurance are applicable to any accidents or incidents that involve my vehicle, including those that occur while I am serving as a volunteer driver for the BFP.
7. PHOTOGRAPHIC RELEASE. I grant and convey unto BFP all right, title, and interest in any and all photographic images and video or audio recordings made by BFP during my work for BFP, including, but not limited to, any royalties, proceeds, or other benefits derived from such photographs or recordings.
8. OTHER. I understand that it is my desire to further the work of the BFP by performing services as a Volunteer. I undertake to perform said services without compensation and agree and acknowledge that, in performing said services, I am not acting as an employee. I expressly agree that this Release is intended to be as broad and inclusive as permitted by the laws of the Commonwealth of Massachusetts in the United States of America, and that this Release shall be governed by and interpreted in accordance with the laws of the Commonwealth of Massachusetts. I agree that in the event that any clause or provision of this Release shall be held to be invalid by any court of competent jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining provisions of this Release which shall continue to be enforceable.
______________________________ Signature of Volunteer
________________________________ Printed Name of Volunteer
I, as Parent or Guardian Volunteer with legal responsibility for the volunteer, consent and agree to the terms and conditions as stated in the Volunteer Waiver and Release of Liability as provided above, and for myself, my next of kin, heirs, executors, administrators, successors, assigns, personal and legal representatives, hereby release and agree to indemnify and hold harmless the Releasees from any and all claims and liabilities arising out of or in any way connected with my minor child or ward’s participation in the events and volunteer activities as provided above, even if arising from the negligent acts or omissions of the Releasees.
_____________________________ Relationship to Child: ___________________ Signature of Parent/Legal Guardian Date:___________________
___________________________ Printed Name