Volunteer Waiver & Release

Volunteer liability waiver and release form for Bartonville Parks & Recreation activities.

First Name * *

Last Name * *

Email * *

Phone * *

Address * *

Date of Birth * *

Emergency Contact Name * *

Emergency Contact Phone * *

Volunteer Activity / Event

VOLUNTEER WAIVER AND RELEASE OF LIABILITY

In consideration of being permitted to participate as a volunteer in activities sponsored by the Village of Bartonville Parks & Recreation Department, I hereby agree to release, waive, discharge, and covenant not to sue the Village of Bartonville, its officers, agents, and employees from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, damage, or injury that may be sustained by me while participating in such activity.

I understand that volunteer activities may involve physical risks. I voluntarily assume all risks of injury or harm while participating in Village of Bartonville Parks & Recreation volunteer activities.

I certify that I am in good physical condition and have no medical conditions that would prevent me from safely participating as a volunteer.

I have read and agree to the Volunteer Waiver and Release of Liability * *

Volunteer is under 18 years of age (parent/guardian signature required)

Parent / Guardian Name (if under 18)

Parent / Guardian Signature (if under 18)

Draw with your mouse, finger or pen.

Volunteer Signature * *

Draw with your mouse, finger or pen.