By my signature set forth below, I further authorize KIDS BEATING CANCER, INC. or any of its agents, directors, officers, servants
or employees to photograph, film and/or electronically record interviews with me in such manner as they choose.
I further authorize KIDS BEATING CANCER, INC. or any person or organization participating in the taking of said photographs,
films and/or electronically recorded interviews to distribute now or at any time in the future, all of said photographs, films and/or
electronically recorded interviews to anyone including the general public, magazines, newspapers, television and radio stations, and/or
any other organization or person that customarily presents information or news to the general public. I further authorize KIDS
BEATING CANCER, INC. to disclose to the general public, as well as to television and radio stations, newspapers or magazines, or
any other form of news or public media, now or at any time in the future, my name and the details of the volunteer opportunity in
which I am participating.
Release, Waiver of Liability and Indemnity Agreement
The undersigned (Volunteer), for himself/herself, his/her personal representatives, heirs and next of kin, in consideration for being
permitted to work as a Volunteer for KIDS BEATING CANCER, INC. (KBC), a Florida not for profit corporation, whether at the
KBC Village, or off site, including in any areas where any activity related to events for KBC’s guests occur, and other good and
valuable consideration, the receipt of which is hereby acknowledged, voluntarily and knowingly executes this Release, Waiver of
Liability and Indemnity Agreement (Agreement), with the express intention of giving a release and indemnification in favor of KBC
(including their officers, directors, members, agents, servants, employees, and assigns) and giving other covenants and warranties as
follows:
- Volunteer, with the intention of binding himself or herself, legal representatives, and assigns expressly release and discharges KBC
from all claims or demands for injury, loss or damage, whatsoever, which Volunteer or anyone claiming through or under Volunteer,
may have arising from Volunteer’s association with KBC and with the children and their parents who utilize the services and/or
facilities of KBC, regardless of whether the injury, loss or damage results from KBC’s negligence or fault. Volunteer expressly
assumes any and all risks which may arise during the Volunteer work, which may include but is not limited to interacting with the
children, playing games, serving food, and assisting in clean up, knowing that Volunteer may refuse to perform any activity or task
requested. Volunteer further agrees that Volunteer is barred from bringing any claim or demand against KBC for any such injury, loss
or damage.
- By signing this Release, Waiver of Liability and Indemnity Agreement, Volunteer intends to also release the officers and directors
of KBC, as set forth above, regardless of whether any injury, loss or damage results from the negligence or fault of the KBC officers
and directors.
- VOLUNTEER FURTHER EXPRESSLY AGREES AND ACKNOWLEGES THAT VOLUNTEER HAS CAREFULLY READ
THIS AGREEMENT, KNOWS OF ITS CONTENTS, UNDERSTANDS IT, AND VOLUNTARILY SIGNS IT, and further agrees
that no oral representations, statements or inducements apart from the foregoing written agreement have been made.
KBC Infection Control and Universal Precautions Acknowledgement:
By volunteering in a setting which caters to children with life-threatening illnesses, you may be at risk of exposure to infections.
Please use the following guidelines while volunteering for Kids Beating Cancer.
- Hand washing is the single most effective method of controlling infections. Wash your hands before, during, and after your shift.
- Always wear disposable gloves when required by the department in which you volunteer.
- Never perform tasks that require touching items or surfaces that are visibly soiled with blood or other bodily fluids.
- If you touch an item or surface soiled with blood or bodily fluids, wash your hands immediately with soap and water. Then report
the instance immediately to a staff person.
- Never touch a needle or syringe.
- Always wear a mask or use a mechanical ventilation device in those very rare instances when you are called upon, if qualified, to
perform CPR.
- Recognize and avoid contact with Sharp Containers, which are indicated by a red bag or labeled as a Sharps Container.
- Always report any potential hazard or possible hazardous incident to a staff person immediately.
I have read the above guidelines and understand that these are necessary for my safety and welfare.
