Waiver – The Harbaugh House

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The Harbaugh House

EMERGENCY CONTACT AND RELEASE

Emergency Contact Information

Volunteer Name(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone(Required)

Email(Required)

In case of an emergency, contact

Name(Required)

Relationship(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone(Required)

Email(Required)

Any allergies, medications, or other information needed in an emergency:(Required)

Release and Waiver of Liability

PLEASE READ CAREFULLY! THIS IS A LEGAL DOCUMENT THAT AFFECTS YOUR LEGAL RIGHTS!

This Release and Waiver of Liability (the “Release”) executed on this date(Required)

by full name(Required)

(the “Volunteer”) in favor of The Harbaugh House, a non-profit corporation, and its directors, officers, employees, and agents.

The Volunteer desires to work as a volunteer for The Harbaugh House and engage in the activities related to being a volunteer for The Harbaugh House (the "Activities"). The Volunteer understands that the Activities may include physical labor, exposure to hazardous conditions, or other circumstances that may result in personal injuries.

The Volunteer hereby freely, voluntarily, and without duress executes this Release under the following terms:

1. Release and Waiver. Volunteer does hereby release and forever discharge and hold harmless The Harbaugh House and its successors and assigns from any and all liability, claims, and demands of whatever kind or nature, either in law or in equity, that arise or may hereafter arise from Volunteer's Activities with The Harbaugh House

VOLUNTEER UNDERSTANDS THAT THIS RELEASE DISCHARGES THE HARBAUGH HOUSE FROM ANY LIABILITY OR CLAIM THAT THE VOLUNTEER MAY HAVE AGAINST THE HARBAUGH HOUSE WITH RESPECT TO ANY BODILY INJURY, PERSONAL INJURY, ILLNESS, DEATH, OR PROPERTY DAMAGE THAT MAY RESULT FROM VOLUNTEER'S ACTIVITIES WITH THE HARBAUGH HOUSE, WHETHER CAUSED BY THE NEGLIGENCE OF THE HARBAUGH HOUSE OR ITS OFFICERS, DIRECTORS, EMPLOYEES, OR AGENTS OR OTHERWISE. VOLUNTEER ALSO UNDERSTANDS THAT THE HARBAUGH HOUSE 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 IN THE EVENT OF INJURY OR ILLNESS.

2. Medical Treatment. Volunteer does hereby release and forever discharge THE HARBAUGH HOUSE from any claim whatsoever which arises or may hereafter arise on account of any first aid, treatment, or service rendered in connection with the Volunteer's Activities with THE HARBAUGH HOUSE .

3. Assumption of the Risk. The Volunteer understands that the Activities may involve work that may be hazardous to the Volunteer, including, but not limited to, physical labor, exposure to hazardous conditions, or other circumstances that may result in personal injuries, and transportation to and from the work sites. Volunteer hereby expressly and specifically assumes the risk of injury or harm in the Activities, and releases THE HARBAUGH HOUSE from all liability for injury, illness, death, or property damage resulting from the Activities.

4. Insurance. The Volunteer understands that, except as otherwise agreed to by THE HARBAUGH HOUSE in writing, THE HARBAUGH HOUSE does not carry or maintain health, medical, or disability insurance coverage for any Volunteer. Each Volunteer is expected and encouraged to obtain his or her own medical or health insurance coverage.

5. Photographic Release. Volunteer does hereby grant and convey unto THE HARBAUGH HOUSE all right, title, and interest in any and all photographic images and video or audio recordings made by THE HARBAUGH HOUSE during the Volunteer’s Activities with THE HARBAUGH HOUSE, including, but not limited to, any royalties, proceeds, or other benefits derived from such photographs or recordings.

6. Other. Volunteer expressly agrees that this Release is intended to be as broad and inclusive as permitted by the laws of the State of New Jersey, and that this Release shall be governed by and interpreted in accordance with the laws of the State of New Jersey. Volunteer also agrees 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.

IN WITNESS WHEREOF, Volunteer has executed this Release as the day and year first above written.

Volunteer(Required)

Witness

PARENT / GUARDIAN WAIVER FOR MINORS

18 years old

I am at least 18 years of age

In the event that the participant is under the age of consent (18 years of age), then this Release must be signed by a parent or guardian, as follows:

I HEREBY CERTIFY that I am the parent or guardian of(Required)

named above and do hereby give my consent without reservation to the foregoing on behalf of this individual.

Parent / Guardian Name(Required)

Relationship to Minor(Required)

Signature

COVID-19 Liability Waiver and Assumption of Risk

In consideration of being allowed to participate in recreational activities (skating, tennis, walking) or other programs, or being on premises of Four Winds Recreation Center (aka – Brady’s Run Ice Rink and Tennis Facility – the “Facility”), the below signed participant, and the participant’s parent(s) or legal guardian(s) if the participant is a minor, agrees as follows:

1. I am aware that the novel coronavirus (“COVID-19”) is an extremely contagious virus and that it is currently believed that COVID-19 spreads through person-to-person contact.

2. I am familiar with the Center for Disease Control and Prevention (”CDC”) guidelines regarding COVID-19, which are located at https://www.coronavirus.gov and https://www.cdc/gov/coronavirus/2019-ncov/index.html. I acknowledge and understand that the circumstances regarding COVID-19 are changing from day-to-day, and that the CDC guidelines are regularly modified and updated. I accept full responsibility for familiarizing myself with the most recent updates, and making informed choices to take precautionary measures to protect myself and others.

3. In addition to the CDC guidelines, I agree to abide by any and all policies or postings published to the general public at the Facility.

4. By signing this agreement, I acknowledge that I am aware of the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 at the Facility, and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at the Facility may result from the actions, omissions, or negligence of myself and others.

5. I agree that, in the event that I suspect I became exposed to or infected by COVID-19 at the Facility and I elect to seek testing and/or treatment as a result therefrom, I will be responsible for payment of any and all medical services and testing services.

6. I voluntarily, choose to assume all of the foregoing risks and accept sole responsibility for any injury, illness, permanent disability, or death related to COVID-19 arising from or in connection with my presence at the Facility. I hereby release and hold harmless the Facility, their employees, agents, directors, officers and representatives and other participants from and against all liabilities (statutory or otherwise) for claims, suits, demands, judgments, costs, interest and expense (including but not limited to attorney’s fees and disbursements) for injury, illness, permanent disability, or death related to COVID-19 arising from or in connection with mine or my child(ren)’s presence at the Facility, EVEN IF ARISING FROM THE NEGLIGENCE, ACTS OR OMISSIONS OF THE RELEASED PARTIES.

Agreement(Required)

I HAVE READ AND UNDERSTAND THIS AGREEEMENT AND I AM AWARE THAT BY SIGNING BELOW I MAY BE WAIVING CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE.

Participant Signature(Required)

Parent Guardian Signature(Required)

Participant Name(Required)

In an effort to reduce the risk of Covid exposure to The Harbaugh House employees, all volunteers must complete the following screening questions:

Volunteer Name(Required)

Phone Number(Required)

Self-Declaration by Visitor

Have you traveled to any country outside of the US or have been in close contact with anyone who has traveled outside of the US within the last 14 days?(Required)

Have you had close contact with or cared for someone diagnosed with COVID-19 within the last 14 days?(Required)

Have you experienced any cold or flu-like symptoms in the last 14 days (fever, cough, shortness of breath or other respiratory problem)?(Required)

** Volunteers answering yes to any of the above questions will not be permitted access to THE HARBAUGH HOUSE facility**

Volunteer signature