Howdy from Henry’s Place! We’re excited for our Annual Service Day coming up this April 20th. The event will be from 9:30am – 4:00pm. Come early for Coffee, Donuts, and Fellowship as we prepare our hearts and bellies to work hard! Stay around for Lunch and grab some snacks and drinks throughout the day if you need. If you’re coming, PLEASE RSVP, so we know how many people to expect to have projects ready for you! "*" indicates required fields Name* First Last Preferred PhoneThis is simply for updates for that day in case something happens (like a storm is coming through). You will not be spammedPreferred Email Number of Volunteers with You*INCLUDING YOURSELF 1 2 3 Other What Are You Good At?*To help prepare projects, tell us what you're good at and we'll have something ready for you! Painting Labor Building Carpentry Cleaning Detailing Decorating Mowing Other Consent* I agree to the WaiverContact the Camp Director, Tony Spatafore, at (702-420-4145) or CampDirector@HenrysPlace.org if you have any questions or concerns. MEDICAL RELEASE: In the event of a medical emergency, I hereby give permission to the physician selected by the Camp Director to hospitalize, secure proper treatment for, and to order injection, anesthesia, or surgery for the registered Volunteer named on this form. I also agree to pay for any fees incurred, and I understand that Henry's Place and its staff will not be held responsible or liable for any related expenses. COVID-19 STATEMENT OF UNDERSTANDING: I understand that volunteer activities will involve an inherent risk of contracting COVID-19. I understand that Henry's Place staff will make every reasonable effort to comply with any mandatory guidelines but that 100% compliance with person-to-person spacing and mask-wear is not reasonably possible. I further understand that this camp program may be immediately terminated if any camper or staff member shows evidence of COVID-19 symptoms or infection. I understand that the Release and Waiver of Liability, Assumption of Risk, and Indemnity Agreement below applies equally and fully to COVID-19 exposure and/or contraction. CONSENT TO USE PHOTOS AND VIDEOS: I hereby grant to Henry's Place and its agents (volunteer or paid) permission to store and/or use my likeness in photograph(s)or video(s) in any and all of its publications and in any and all other media, in perpetuity, for the purpose of documenting and promoting Henry's Place activities and mission . I will make no monetary or other claim against Henry's Place for the use of the photograph(s)/video(s). RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT: With regard to the registered volunteer named on this form, I fully understand that volunteer activities that may involve risks of serious bodily injury, including permanent disability, paralysis and death, which may be caused by my own actions, or inactions, those of others on site, the conditions in which the activity takes place, or the negligence of the Releasees named below, and that there may be other risks either not known to me or not readily foreseeable at this time, and I fully accept and assume all such risks and all responsibility for losses, cost, and damages myself may incur as a result my participation in the Service Day Additionally, I am aware of the inherent risks, both natural and man-made, associated with an outdoor and/or camp setting, independent of organized events or volunteer activity. On behalf of my minor camper, I further fully accept and assume all such risks and all responsibility for losses, cost, and damages my minor camper may incur during Henry's Place Camp activities. I understand the nature of volunteer work and believe to be qualified to participate in such activity. I HEREBY RELEASE, DISCHARGE, COVENANT NOT TO SUE AND AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS Henry’s Place, its respective administrators, directors, agents, officers, volunteers, and employees, other participants, any sponsors, advertisers, owners and lessors of premises on which the activity takes place, (each considered one of the “RELEASEES” herein) from all liability, claims, demands, losses or damages on my account caused or alleged to have been caused in whole or in part by the negligence of the Releasees or otherwise, and further agree that if, despite this release, I, or anyone on my behalf makes a claim against any of the above Releasees, I WILL INDEMNIFY, SAVE AND HOLD HARMLESS each of the Releasees from any litigation expenses, attorney fees, loss liability, damage, or cost any Releasee may incur as the result of any such claim. The provisions of this section apply equally and fully to exposure to and/or contraction of COVID-19. I have read this RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT, understand that I have given up substantial rights by signing it and have signed it freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid the balance, notwithstanding, shall continue in full force and effect.
