Release (Volunteer) and Consent for Background Check

Release (Volunteer) and Consent for Background Check

For and in consideration of being permitted to perform volunteer services to assist the Arkansas Agriculture Department (“AAD”), I and my successors, heirs, assigns, executors, administrators, spouse and next of kin do hereby release and forever discharge the Arkansas Agriculture Department and any and all of its subdivisions, commissioners, officers, employees, agents, and other volunteers from any and all manner of claims, causes of action or liability which I now have, or may have at any time in the future, against the Arkansas Agriculture Department, its subdivisions, commissioners, officers, employees, agents, or other volunteers arising out of or pertaining to any injury, loss, damage or harm of any kind which may result from the activities or services I have requested to participate in or any other damages which may occur to me while I am voluntarily assisting the Department in conducting its affairs.

In addition to the above, and for the same consideration previously stated, I and my successors, heirs, assigns, executors, administrators, spouse and next of kin do hereby agree to indemnify, defend, protect and hold harmless the Arkansas Agriculture Department, its subdivisions, commissioners, officers, employees, agents, and volunteers from and against any and all manner of claims, causes of action, or liability arising out of any accident, injury or damage to me or any others occurring while I am participating in the referenced activity or accompanying Department personnel or as a result of any services or equipment they instruct me in the operation thereof and any consequential damage therefrom.

I also understand and consent to allowing AAD to conduct background checks as deemed appropriate by AAD, including, but not limited to criminal history and/or driving history background checks. AAD will keep such information confidential to the extent allowed by law.

This release and consent shall remain in full force and effect until or unless revoked in writing by both myself and an officer or division manager of the Arkansas Agriculture Department; and, in any event, it shall remain in full force and effect so long as I am participating in a voluntary and unpaid status for that agency and shall be binding on me and the Arkansas Agriculture Department or any of its subdivisions for any purpose whatsoever at any time after the date hereof.

IN WITNESS WHEREOF, we have hereunto set our hands, and have agreed to the terms of this instrument after having carefully read it in full this _____ day of ______, 20___.

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Division Manager of AAD (Signature) Volunteer (Signature)

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Division Manager of AAD (Print Name) Volunteer (Print Name)

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Volunteer Address

EXPLANATION OF RELEASE

The above release gives up your right to sue or file a claim against the Arkansas Agriculture Department or its employees should you be injured or suffer any other damages while participating in volunteer services for the Department, and requires you to hold the Department harmless from claims by anyone that you might injure or otherwise damage while participating in volunteer services for the Department.

5/17/2017