Gulf Coast Humane Society

Release and Waiver of Liability

This Release and Waiver of liability executed on this______day of _____________, ___________ (year)

By(volunteer)____________________ in favor of the Gulf Coast Humane Society , a nonprofit corporation organized and existing under the laws of the state of Texas, USA.

I, the Volunteer, desire to work as a volunteer for GCHS and engage in the activities related to being a volunteer for any assigned project I wish to work on.  I hereby freely and voluntarily, without duress, execute this release under the following terms:

1. Waiver and Release: I , the Volunteer, release and forever discharge and hold harmless the Gulf Coast Humane Society and its successors from any and all liability, claims and demands of whatever kind of nature, either in law or in equity, which may arise or may hereafter arise form my work at GCHS.

2. Insurance: I understand and acknowledge that this Release discharges GHCS from any claim or that I , the Volunteer may have against GCHS with respect to bodily injury, personal injury, illness, death or property damage that may result from my participation in volunteer activities. I also understand that GHCS is not liable for my (the volunteer) medical expenses. Claims for such incidents should be taken up with the Volunteer’s own insurance carrier.

3. Medical Treatment: I hereby release and forever discharge GHCS from any claim whatsoever that may arise or may hereafter arise on any account of first-aide treatment or other medical services rendered in the connection with an emergency during my volunteer time with GCHS.

4. Assumption of Risk:  I hereby expressly and specifically assume the risk of injury or harm in these activities and release GHCS from all liability for injury, illness, death or property damage resulting from my volunteer activities and participation. I completely understand that there are activities that may be hazardous to me.  I understand that working with shelter animals poses a risk of being bitten, scratched or hurt.

5. Photographic Release: I grant GCHS all right, title and interest in any and all photographic images, video and audio recordings made by GCHS during my volunteer shift.

In case of emergency contact:

Name: ________________________________

Relationship ____________________________

Address:______________________________________________________________

Home Phone: _______________________________

Alternate Phone: ______________________

Email_____________________________________

By signing this form, I am acknowledging my understanding of this document.

Volunteer Name: (print) _____________________________________

Signature: ______________________________________________

Date: _________________

Parent or Guardian signature

if under 18:______________________________________________