Waiver & Release of All Claims

Name:

Phone Number: / E-Mail Address:
Do you want to be added to our e-mail list for newsletters?
YES NO
Address: / City: / State: / Zip:
Why do you want to take part in volunteer activities for the National Orphan Train Complex?
Skills/Interests and/or Comments
Job Options:
Saturday Volunteer (Open the museum from 10am – 4pm)
Gift Shop Management (Create price stickers, manage stock, arrange merchandise, etc.)
Docent (Guide tours as needed)
Yard work (watering, weeding, etc.)
Misc. Office Support (as needed)
Available Hours:
Tuesday / Wednesday / Thursday / Friday / Saturday
1) In case of emergency, please notify

Name Relationship

Home Phone Business Phone
2) In case of emergency, please notify

Name Relationship

Home Phone Business Phone

Waiver & Release of all claims:

By signing, I swear and attest that I am capable, competent and willing without duress or force, and agree to hold harmless, waive and release all claims, loss and damages, including negligence, against the National Orphan Train Complex, of bodily injury, including death and property damage as a result of or rising out of my volunteering in the work done for the National Orphan Train Complex. Furthermore, I believe that my volunteer work is to help the National Orphan Train Complex in their mission of preserving the stories of Orphan Train Riders and assisting them and their families in finding information regarding their past; and I do the job willingly and with full knowledge that there will be no payment for my assistance.

I release and hold harmless, promising not to sue the National Orphan Train Complex for any first aid given while waiting for professional medical assistance, by any representative or volunteer of the National Orphan Train Complex. I agree it is my sole responsibility for payment of any medical bills, paid or not paid for by my own coverage, including deductibles and co-pays from injuries, sickness, or disease arising out of, or alleged to have been sustained while volunteering.

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Signature of VolunteerDate

Print Name

Media Release Form

On behalf of myself, my heirs, personal representatives, and executors, I allow the National Orphan Train Complex, Inc. to use any photographs, video, oraudio taken of me for use in public relations efforts. Also, all photographs that Isubmit to the National Orphan Train Complex, Inc. will remain the property of thephotographer. The National Orphan Train Complex, Inc. will have the rights to usethese photographs for marketing materials or in any other ways that the NationalOrphan Train Complex, Inc. sees fit.

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Date

Name of individual in picture/video/audio

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Date

Parent or Guardian, if volunteer is under age 18.