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KCC Volunteer Participant
Assumption of Risks and Release of Liability
Indemnification
Version dated: March 20, 2004
Functions and Activities
I understand that it is a joy and privilege to participate as a
volunteer in tasks that support the mission and vision of Kagyu
Changchub Chuling (KCC), a nonprofit Oregon corporation. I am donating
my labor, by my free choice, and will perform
assigned tasks in a responsible manner.
I acknowledge that certain tasks at the Portland KCC center, and
many of the tasks involving construction, repair and maintenance at the
Ser Cho Osel Ling retreat lands in Goldendale, Washington, require
physical strength as well as
competence in operating specific tools or machines. There is risk of
injury if the tools, machinery or equipment are not used properly. When
accepting a volunteer assignment, I will take into consideration my
physical condition, experience and abilities.
I also acknowledge that under some circumstances hazardous
conditions (for instance, icy or irregular surfaces) may exist at the
center and retreat land, and that such conditions may also exist with
man-made structures, equipment and
vehicles, even when such equipment or vehicles are not actually in
operation.
I also understand that there are risks from other individuals and, of course,
many unknown or unanticipated risks.
This release also includes minors under my control.
Release of Liabiliy
Prior to my participation in volunteer activities I acknowledge that
there are certain risks associated with these activities, including, by
way of example, physical injury due to activity-related accidents,
illness or even death. By signing this Release of Liability Form, I
expressly warrant that I am capable of withstanding both the physical
and mental demands of these activities. I release Kagyu Changchub
Chuling and its teachers, officers and directors, employees, volunteers
and agents from any claim I may have against them as a result of injury
or illness I may incur
during the course of participation in these activities. This Release of
Liability is also intended to cover all claims that members of my
family or estate, heirs, representatives or assigns may have against
KCC.
Indemnification
I agree to indemnify and hold KCC harmless from any claim made by me or a minor under my control.
I further agree to indemnify and hold KCC and its teachers, officers
and directors, employees, volunteers and agents harmless from any and
all claims, including but not limited to negligence, arising from my
participation in its activities and programs or my presence on the
premises.
Please confirm your agreement to this Release by
placing your initials in the place provided below. You may include any
limitations you negotiate with KCC:
_____"I, the undersigned, agree to the release with KCC as stated
above. I negotiated this Release or had the opportunity to do so."
Dated: ____________________
Sign Name: __________________________________
Print name: __________________________________
Address:__________________________________________________
_________________________________________________________________
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