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Volunteer Agreement & Release from Liability Form
Name (individual) / Group: ______________________________________________________________
Group: _____Individual:____ (Mark one) Group Code: ________________________(office use only)
Volunteer Address: ___________________________________________________________________
City: ______________________________________________________State: _______Zip: _________
Phone: (_______) _____________________________________________________________________
Email address: _______________________________________________________________________
1. I, ___________________________ (name) on this _____ day of ________________________ in the
year _______, acknowledge that I have voluntarily applied to HABITAT FOR HUMANITY OF RIVER-
SIDE (Habitat) for construction and other volunteer activities at their construction site(s) and/or other lo-
cations.
2. I am aware that construction is a hazardous activity. I am voluntarily participating in the activities of con-
struction with the knowledge of the danger involved and with the knowledge that medical facilities may
not be available in the event of injury to me. I hereby agree to accept all risks of injury and death, and
verify this statement by placing my initials here_________ (initials).
3. As consideration for being permitted by Habitat to participate in these activities and use their tools and
facilities, I hereby agree that I, and my assignees, heirs, distributees, guardians, and legal representa-
tives will not make claim against, sue, or attach the property of Habitat, or the suppliers of any tools or
equipment I will use, for injury or damage resulting from my participation in any Habitat activities, and I
hereby release Habitat from all actions, claims, or demands that I, my assignees, my heirs, distributees,
guardians, and legal representatives now have or may hereafter have for injury or damage resulting
from my participation in any Habitat activities. _______ (initials)
4. I hereby release and forever discharge Habitat from any claims whatsoever which arise or may hereafter
arise on account of any first aid, treatment, or service rendered in connection with participation in Habi-
tat's construction. _______ (initials)
5. I understand that although Habitat carries medical insurance for volunteers, it is considered secondary
coverage and my own health insurance is primary coverage. ______ (initials)
6. I agree that this Volunteer Agreement (this "Agreement") is intended to be as broad and inclusive as per-
mitted by the laws of the State of California, and that this Agreement shall be governed by and inter-
preted in accordance with the laws of the State of California. I agree that in the event that any clause or
provision of this Agreement shall be held to be invalid by any other court of competent jurisdiction, the
invalidity of such clause or provision shall not otherwise affect the remaining provisions of this Agree-
ment, which shall continue to be enforced. ______ (initials)
7. I hereby agree that Habitat may use my photographic image or likeness taken from my participation in
any Habitat activities for any purpose including for use in promotional materials and on the Internet
_______(initials)
2180 Iowa Avenue
Riverside CA 92507
(951)787-6754
www.habitatriverside.org