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Your information


Required fields are marked with an asterisk (*). One of the fields below is a file upload/attachment, the file size must be less than 10MB.
First Name *
Last Name *
Birthday *

A valid date as MM/DD/YYYY (for example: 11/30/2015)
Mobile Phone *

For example, 123-456-7890
Street Address *
City *
State *
ZIP Code *
What volunteer activities are you interested in? (optional)











Name of the church only if you are volunteering as a part of the church (optional)
Name of the business/group only if you are volunteering as a part of the business/group (optional)
Emergency Contact Name *
Emergency Contact Phone Number *
Emergency Contact Relationship *
Please list any medical conditions, if any. (optional)
Please list any medical allergies, if any. (optional)

Waiver


Who is this registration for?

Volunteer Release and Waiver of Liability Form

This Release and Waiver of Liability release PACK People of Action Caring for Kids Inc (“PACK”), a 501(c)(3) corporation organized and existing under the laws of the State of Georgia and each of its directors, officers, employees, and agents. The Volunteer desires to provide volunteer services for PACK and engage in activities related to serving as a volunteer both on-site and off-site.

Volunteer understands that the scope of Volunteer’s relationship with PACK is limited to a volunteer position and that no compensation is expected in return for services provided by Volunteer; that PACK will not offer any benefits traditionally associated with employment to Volunteer; and that Volunteer is responsible for his/her own insurance coverage in the event of personal injury or illness as a result of Volunteer’s services to PACK.

1. Waiver and Release: I, the Volunteer, release and forever discharge and hold harmless PACK and its successors and assigns from any and all liabilities, claims, and demands of whatever kind of nature, either in law or in equity, which arise or may hereafter arise from the services I provide to PACK. I understand and acknowledge that this Release discharges PACK from any liability or claim that I may have against PACK with respect to bodily injury, personal injury, illness, death, or property damage that may result from the services I provide to PACK or occurring while I am providing volunteer services.
2. Insurance: Further, I understand that PACK does not assume any responsibility for or obligation to provide me with financial or other assistance, including but not limited to medical, health, or disability benefits or insurance. I expressly waive any such claim for compensation or liability on the part of PACK beyond what PACK may offer freely in the event of injury or medical expenses incurred by me.
3. Medical Treatment: I hereby Release and forever discharge PACK from any claim whatsoever which arises or may hereafter arise on account of any first-aid treatment or other medical services rendered in connection with an emergency during my tenure as a volunteer with PACK.
4. Allergies: I understand that PACK handles a variety of food products on a rotating basis and does not assume any responsibility for potential allergic reactions to these products. I understand that it is solely my responsibility to inquire about food products that are handled at PACK and make appropriate decisions regarding volunteering.
5. Assumption of Risk: I understand that the services I provide to PACK may include activities that may be hazardous to me. As a volunteer, I hereby expressly assume the risk of injury or harm from these activities and release PACK from all liability.
6. Photographic Release: I grant and convey to PACK all rights, titles, and interests in any and all photographs, images, video, or audio recordings of me or my likeness or voice made by PACK in connection with my providing volunteer services to PACK.
7. Email list: I agree to be added to PACK's email list to receive newsletters and periodic communications. I understand that I may opt out of the email list in the future.
8. Other: As a volunteer, I expressly agree that this Release is intended to be as broad and inclusive as permitted by the laws of the State of Georgia and that it shall be governed by and interpreted in accordance with those laws. I agree that in the event that any clause or provision of this Release is deemed invalid, the enforceability of the remaining provisions of this Release shall not be affected.
9. Minor(s): I understand that I am solely responsible for all minors that I bring with me while I am serving PACK as a volunteer. I understand that all above clauses (1-7) apply to the minor(s) accompanied by me and that PACK is released from any liability or claim against any bodily injury, personal injury, illness, death, or property damage. I understand that minor(s) under the age of fourteen (14) years old must be my own child(ren) or child(ren) under my legal guardianship and must be accompanied by me at all times. By clicking the “I accept PACK’s volunteer waiver form” box on our volunteer sign-up form, I express my understanding and intent to enter into this Release and Waiver of liability willingly and voluntarily.