Please print, sign, and bring with you on first volunteer day. This is a legal document.
This Release and Waiver of Liability (the “Release”) executed on this _________________________________ day of
____________________________, 20_____, by ____________________________________ ____________________,
a minor child (the “volunteer”), and ________________________________________________ the parents having legal
custody and/or the legal guardians of the volunteer (the “Guardians”), in favor of Habitat for Humanity International,
Inc., a nonprofit corporation, and Barron County Habitat for Humanity, Inc., a Wisconsin nonprofit corporation, their
directors, officers, employees, and agents (collectively, “Habitat”). (Note that any additional parent or guardian should
sign the Release).
The Volunteer and Guardians desire that the Volunteer work as a volunteer for Habitat engage in the activities related to
being a volunteer (the “Activities”). The Volunteer and the Guardians understand that the Activities may include
constructing and rehabilitating buildings, working in the Habitat offices, and living in housing provided for volunteers of
Habitat.
The Volunteer and Guardians do hereby freely, voluntarily, and without duress execute this Release under the following
terms:
Release and Waiver: Volunteer and Guardians do hereby release and forever discharge and hold harmless Habitat and
its successors and assigns from any and all liability, claims, and demands of whatever kind or nature, either in law or in
equity, which arise or may hereafter arise from Volunteer’s Activities with Habitat.
Volunteer and Guardians understand that this Release discharges Habitat from any liability or claim that the Volunteer
or Guardians may have against Habitat with respect to any bodily injury, personal injury, illness, death, or property
damage that may result from Volunteer’s Activities with Habitat, whether caused by the negligence of Habitat or its
officers, directors, employees, or agents or otherwise. Volunteer and Guardians also understand that Habitat 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 in the event of injury or illness.
It is the policy of Habitat that children under the age of 16 are not allowed on a Habitat work site while there is
construction in progress. It is further the policy of Habitat that, while children between the ages of 16 and 18 may be
allowed to participate in construction work, ultra hazardous activity, such as using power tools, excavation, demolition
or working on rooftops is not permitted by anyone under the age of 18.
Medical Treatment: Volunteer and Guardians do hereby release and forever discharge Habitat from any claim
whatsoever which arises or may hereafter arise on account of any first aid, treatment, or service rendered in connection
with the Volunteer’s Activities with Habitat or with the decision by any representative or agent of Habitat to exercise the
power to consent to medical or dental treatment as such power may be granted and authorized in the Parental
Authorization for Treatment of a Minor Child.
Assumption of the Risk: The Volunteer and Guardians understand that the Activities may include work that may be hazardous to the Volunteer, including, but not limited to, construction, loading and unloading, and transportation to and
from the work sites.
Volunteer and Guardians hereby expressly and specifically assume the risk of injury or harm in the Activities and release
Habitat from all liability for injury, illness, death, or property damage resulting from the Activities.
Insurance: The Volunteer and Guardians understand that, expect as otherwise agreed to by Habitat in writing, Habitat
does not carry or maintain health, medical, or disability insurance coverage for any Volunteer.
Each Volutneer is expected and encouraged to obtain his or her own medical or health insurance coverage.
Photographic Release: Volunteer and Guardians do hereby grant and convey unto Habitat all right, title and interest in
any and all photographic images and video or audio recordings made by Habitat during the Volunteer’s Activities with
Habitat, including, but not limited to, any royalties, proceeds, or other benefits derived from such photographs or
recordings.
Other: Volunteer and Guardians expressly agree that this Release is intended to be as broad and inclusive as permitted
by the laws of the State of Wisconsin, and that this Release shall be governed by and interpreted in accordance with the
laws of the State of Wisconsin. Volunteer agrees that in the event that any clause or provision shall not otherwise affect
the remaining provisions of this Release which shall continue to be enforceable.
Witness: _______________________________________________ Volunteer: ___________________________________________
Print Name Print Name
Witness: _______________________________________________ Volunteer: ___________________________________________
Signature Signature
Witness: _______________________________________________ Parent/Guardian: _____________________________________
Print Name Print Name
Witness: _______________________________________________ Parent/Guardian: _____________________________________
Signature Signature
Witness: _______________________________________________ Parent/Guardian: _____________________________________
Print Name Print Name
Witness: _______________________________________________ Parent/Guardian: _____________________________________
Signature Signature