Youth Volunteer Waiver
This Liability and Photo Release waiver (the "Agreement") is entered into by and between Monroe County Humane Association (MCHA) with its principal offices at 3410 S. Walnut St., Bloomington, Indiana 4740 and the signee on this form.
I give the Monroe County Humane Association permission to use names, photographs, and videotapes, of my dependent for promotional, fundraising, and educational purposes and programs to promote the welfare and respect of all animals. I hereby release the Monroe County Humane Association, their officers, directors, and agents from all liability and financial obligations related to the use of any photographs or videos of myself or my dependents.
To permit my child to participate in Monroe County Humane Association activities. Participation includes, but is not limited to, contact with animals such as dogs, cats, rabbits, snakes, horses and ferrets and observation of birds. Contact may include, but is not limited to, the following: brushing of animals, petting animals, playing with animals, feeding animals and building enrichment enclosures for animals;
To release and hold harmless the Monroe County Humane Association, and its employees, officers, and agents for any claim or claims arising out of any incident connected with or in any way related to my child’s participation, including claims for personal injury, property damage, or any other type of harm or injury, whether such claim might be brought by my child, myself, or by any other party. I understand this release binds my child, myself, my spouse, and all heirs, executors and administrators of those individuals.
By Submitting and providing this form:
I HAVE READ THIS RELEASE AND UNDERSTAND ALL OF ITS TERMS. I SIGN IT VOLUNTARILY, WITH FULL KNOWLEDGE OF ITS SIGNIFICANCE, AND WITH THE INTENT TO BE BOUND BY IT.
Sponsor a Classroom Now!
Just $28 sponsors a
classroom for one year.