YOUR NAME: (required)

ADDRESS:

YOUR E-MAIL: (required)

PHONE NUMBER: (required)

BUSINESS/ORGANIZATION/SCHOOL REPRESENTING:

EVENTS:
 KHFSB Trash-Off KHFSB Tire Clean-Up KHFSB Halloween Carnival

DATE OF EVENT:

EMERGENCY CONTACT:

EMERGENCY PHONE NUMBER:

COMMENTS:

This Release and Waiver of Liability executed on by (the “Volunteer”) in favor of the Keep Historic Fort Stockton Beautiful Board, a board responsible for assisting the city council in establishing a city-wide policy relating to beautifying Fort Stockton and enhancing the environment of the community.

The Volunteer/Organization desires to work as a volunteer for Keep Historic Fort Stockton Beautiful and engage in the activities relating to being a volunteer (the “Activities”). The Volunteer/Organization understands that the Activities may include removing debris from roadsides, clearing a variety of weeds and trash from uneven and unkempt site(s), and disposing of such materials in a proper manner.

The Volunteer/Organization hereby freely, voluntarily and without duress executes this Release under the following terms:

1. RELEASE AND WAIVER. Volunteer/Organization does hereby release and forever discharge and hold harmless Keep Historic Fort Stockton Beautiful and its successors and assigns from any and all liability, claims, and demands of whatever kind or nature, either in law in equity, which arise or may hereafter arise from Volunteer’s Activities through Keep Historic Fort Stockton Beautiful. Volunteer/Organization understands that this release discharges Keep Historic Fort Stockton Beautiful from any liability or claim that the Volunteer/Organization may have against Keep Historic Fort Stockton Beautiful with respect to bodily injury, illness, or death that may result from Volunteer’s Activities with Keep Historic Fort Stockton Beautiful. Volunteer/Organization also understands that Keep Historic Fort Stockton Beautiful does not assume any responsibility for or obligation to provide financial assistance or other assistance, including, but not limited to, medical, health, or disability insurance or in the event of injury or illness.

2. MEDICAL TREATMENT. Volunteer/Organization does hereby release and forever discharge Keep Historic Fort Stockton Beautiful from any claim whatsoever that arises or may hereafter arise on account of any first aid, treatment, or service rendered in connection with the Volunteer’s Activities with Keep Historic Fort Stockton Beautiful. I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during this activity or event.

3. ASSUMPTION OF THE RISK. The Volunteer understands that the Activities including work that may be hazardous to the Volunteer, including, but not limited to, lifting, climbing steep and/or uneven terrain, removing trash and limbs, and working in unsanitary conditions. Volunteer hereby expressly and specifically assumes the risk of injury or harm in the Activities and releases Keep Historic Fort Stockton Beautiful from all liability for injury, illness, death or property resulting from the Activities.

4. PHOTOGRAPHIC RELEASE. Volunteer does hereby grant and convey unto Keep Historic Fort Stockton Beautiful all right, title, and interest in any and all photographic images and video or audio recordings made by Keep Historic Fort Stockton Beautiful during the Volunteer’s Activities with Keep Historic Fort Stockton Beautiful, including, but limited to, any royalties, proceeds, or other benefits derived from such photographs or recordings.

5. OTHER. Volunteer expressly agrees that this Release is intended to be as broad and inclusive as permitted by the laws of the State of Texas, and that this Release shall be governed by the interpreted in accordance with the laws of the State of Texas. Volunteer agrees that in the event that any clause or provision of this Release shall be held to be invalid by any court of competent jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining provisions of this Release which shall continue to be enforceable.

I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL.

ACCEPTANCE
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