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    This Release and Waiver of Liability (the“Release”) is executed on this day, by (the “Volunteer”), in favor of Habitat for Humanity of South Palm Beach County and their respective affiliates, directors,officers, trustees, employees, sponsors, donors, volunteers and agents(collectively, the “Released Parties”).

    I, the Volunteer, desire to work as avolunteer for one or more of the Released Parties without compensation andengage in the activities related to being a volunteer. I understand that myactivities may include but are not limited to the following: working at Habitatfor Humanity offices and worksites; working in or for Habitat for HumanityReStore operations; loading and unloading materials; traveling to and from worksites; constructing and rehabilitating residential buildings; otherconstruction-related activities; and other volunteer activities("Activities").

    I, the Volunteer, hereby freely, voluntarilyand without duress execute this Release under the following terms:

    Release and Waiver. In consideration ofand in order to be allowed to participate in the Activities, I, the Volunteer,do hereby release and forever discharge and hold harmless the Released Partiesand their successors and assigns from any and all liability, claims, demands,costs and damages of any kind, whether arising from tort, contract orotherwise, which I or my heirs, assigns, next of kin or legal representativesmay have or which may hereinafter accrue, arise from, or are in any way relatedto my Activities with any of the Released Parties, including but not limited topersonal injury, bodily injury, illness, property damage, loss or death,whether caused wholly or in part by the simple negligence, fault or othermisconduct of any of the Released Parties or of other volunteers, other thantheir intentional or grossly negligent conduct.

    I understand and acknowledge that by signingthis Release I knowingly assume the risk of injury, harm, damage and lossassociated with the Activities. I also understand that the Released Parties donot assume any responsibility for or obligation to provide financial assistanceor other assistance, including but not limited to medical, health or disabilityinsurance in the event of injury, illness, death or property damage.

    Consent to Transportation and MedicalTreatment. Iconsent to the use of first aid treatment and the use of generic and over thecounter medications and treatments as directed by manufacturer labels, whether administeredby the Released Parties or first aid personnel. In an emergency, I understandthe Released Parties may try to contact the individual listed below as anemergency contact. If an emergency contact cannot be reached promptly, I herebyauthorize the Released Parties to act as an agent for me to consent to anyexamination, testing, x-rays, medical, dental or surgical treatment for me asadvised by a physician, dentist or other health care provider. This includes,but is not limited to, my assessment, evaluation, medical care and treatment,anesthesia, hospitalization, or other health care treatment or procedure asadvised by a physician, dentist or other health care provider. I also authorizethe Released Parties to arrange for transportation of me as deemed necessaryand appropriate in their discretion. I, the Volunteer, do hereby release,forever discharge and hold harmless the Released Parties from any liability,claim, demand, and action whatsoever brought by me or on my behalf which arisesor may hereafter arise on account of any transportation, first aid, assessment,care, treatment, response or service rendered in connection with my Activitieswith any of the Released Parties.

    If the Volunteer is less than 18 years ofage, the parent(s) having legal custody and/or the legal guardian(s) of theVolunteer also hereby release, forever discharge and hold harmless the ReleasedParties from any liability, claim, demand and action whatsoever brought by suchvolunteer or on his/her behalf which arises or may hereafter arise on accountof the decision by any representative or agent of the Released Parties toexercise the power to transport, administer first aid, and consent toassessment, examination, x-rays, medical, dental, surgical or other such healthcare treatment as set forth in the Parental Authorization for Treatment of, andTravel With, a Minor Child.

    Insurance. I understand that, except as otherwiseagreed to by the Released Parties in writing, the Released Parties are under noobligation to provide, carry or maintain health, medical, travel, disability orother insurance coverage for any Volunteer. Each Volunteer is expected andencouraged to obtain his or her own health, medical, travel, disability orother insurance coverage.

    I understand that I am and remain responsiblefor payment of such hospital, physician, ambulance, dental, medical or otherservices obtained for me or my child. I agree that the Released Parties do notassume any responsibility for the payment of such fees or expenses which may beincurred. If I have health insurance, I understand my personal health insuranceis my primary coverage.

    Confidentiality. I agree that in thecourse of my participation in the Activities, I may have access to personaland/or health care information of other persons. I agree to maintain theconfidentiality of such information, to use such information only as necessaryto do my job as a volunteer, and to comply with Habitat for applicable policiesregarding such information.

    Photographic/RecordingRelease. I hereby grant and convey unto Habitat for HumanityInternational, Inc. all right, title and interest in any and all photographsand video/audio/electronic recordings of me, including as to my name, image andvoice, made by or on behalf of any of the Released Parties during my Activitieswith the Released Parties, including, but not limited to, the right to use suchmaterials for any purpose and to any royalties, proceeds or other benefitsderived from them. I understand that I will not have any ownership interest inor to such photographs, images and/or recordings, I have not been provided orpromised any compensation to me, and I hereby waive any rights, privileges orclaims based on any right of publicity, privacy, ownership or any other rightsarising, relating to or resulting from the photographs, images and/orrecordings. I understand and agree that this paragraph also applies to my minorchild(ren) who are volunteering.

    Other. Iexpressly agree that this Release is intended to be as broad and inclusive aspermitted by state law. I further agree that in the event any clause orprovision of this Release is held invalid by any court of competentjurisdiction, the invalidity of such clause or provision shall not otherwiseaffect the remaining clauses or provisions of this Release, which shallcontinue to be enforceable. Further, a waiver of a right under this Release bya Released Party does not prevent the exercise of any other right.

    I have carefully consideredmy decision, the benefits and risks involved and hereby give my informedconsent to participate in all volunteer Activities. I have read and understandthis Release and Waiver of Liability, any questions of mine have been answered,and I voluntarily agree to the above provisions. It is my intent to bind myheirs, next of kin, assigns and legal representative.

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