Volunteers

Festival on the Fourth Volunteer Waiver 2023

TOWN OF PALMER LAKE VOLUNTEER ACTIVITIES WAIVER, RELEASE, & INDEMNIFICATION The following form must be completed for any person participating in volunteer work in the Town of Palmer Lake. This form shall be submitted to the Town of Palmer Lake for Administrative review.

VOLUNTEER INFORMATION

Volunteer Form

Name

First

Last

Phone

Date of Birth

Address

City

State/Province

Zip/Postal

Country

Parent or Legal Guardian (if Participant is under age 18):

Emergency Contact Information

I wish to be placed on an email or mailing list for future projects

yes

I give permission for media coverage of myself and/or my minor child to be disseminated for public relation purposes

yes

Legal

In return for being allowed to participate as a volunteer in the following activities sponsored by or conducted by the Town or occurring on Town property:
(the “Activities”), the undersigned Volunteer or Parent/Legal Guardian of Volunteer if Volunteer is under age 18 (hereafter referred to using “I”, “me”, “my”, or “the Undersigned”), hereby voluntarily enters into this waiver, release, and indemnification.

I, the Undersigned, understand and acknowledge that the Activities are or may be dangerous and do or may involve risks, including but not limited to, risks of bodily injury, personal injury, death, and property loss or damage. I am aware of these risks and further acknowledge that these and other risks may arise from a variety of foreseeable and unforeseeable circumstances connected with the Activities. By signing this agreement, I hereby voluntarily assume all such risks of injury, death, loss, or damage arising out of or related to my participation in the Activities, whether or not caused by the act, omission, negligence, or other fault of the Town, its officers, or its employees, or by any other cause, excepting only willful and wanton conduct of the Town’s officers or employees

By signing this agreement, I hereby waive, exempt, release, and discharge the Town, its officers, employees, and insurers, from any and all claims, demands, and actions for any injury, loss, or damage arising out of or related to the Activities, whether or not caused by the act, omission, negligence, or other fault of the Town, its officers, or its employees. I understand that no volunteer is insured by the Town’s workers compensation insurance

For and on behalf of myself, my successors, representatives, heirs, executors and assigns, I hereby agree to indemnify and hold harmless the Town, its officers, employees, and insurers from and against any and all liabilities, claims, and demands, including any third party claim asserted against the Town, its officers, employees, or insurers, on account of any injury, death, loss, or damage of any kind whatsoever resulting from my participation in the Activities, whether or not caused by the act, omission, negligence, or other fault of the Town, its officers or its employees, or by any other cause, excepting only willful and wanton conduct of the Town’s officers or employees.

I, the Undersigned, authorize the Town to obtain medical attention for me (and my child) in case of emergency if unable to reach the physician stated below, and I hereby release the Town, its officers, employees, and insurers, from any and all liabilities, damages, actions, or causes of action arising from procurement of such medical attention for me (or my child).

I, the Undersigned, agree to abide by all rules and regulations governing Town volunteer activities and to follow the instructions of Town staff while participating in the Activities. I am participating in the Activities solely as a volunteer, gratuitously and without expectation of any compensation.

By signing this agreement, I acknowledge and agree that said agreement is intended to be as broad and inclusive as is permitted by the laws of the State of Colorado. If any portion hereof is held invalid, it is further agreed that the balance of this agreement shall continue in full force and effect. I, the Undersigned,

HEREBY ACKNOWLEDGE AND AGREE THAT I HAVE READ, UNDERSTOOD, AND VOLUNTARILY AGREE TO THE FOREGOING WAIVER, RELEASE, AND INDEMNIFICATION AGREEMENT, AND THAT THIS AGREEMENT SHALL BE BINDING ON ME, MY SUCCESSORS, REPRESENTATIVES, HEIRS, EXECUTORS, AND ASSIGNS. BY SIGNING BELOW, I HEREBY CERTIFY THAT I AM THE PERSON WHOSE NAME APPEARS ON THIS FORM. I UNDERSTAND THAT A DIGITALLLY SIGNED COPY OF THIS DOCUMENT TRANSMITTED BY EMAIL SHALL BE DEEMED TO HAVE THE SAME LEGAL EFFECT AS DELIVERY OF AN ORIGINAL SIGNATURE FOR THE PURPOSES OF VALIDITY, ENFORCEABILITY, AND ADMISSIBILITY.

Signature

Clear

Date

FOR PARTICIPANTS UNDER 18 YEARS OLD BY SIGNING BELOW, I ACKNOWLEDGE THAT I AM THE PARENT OF THE ABOVE-NAMED PARTICIPANT AS THE TERM “PARENT” IS DEFINED IN C.R.S. SECTION 13-22-107(2)(B), AND, IN ADDITION TO EXECUTION OF THE FOREGOING ON BEHALF OF THE PARTICIPANT, I HEREBY WAIVE AND RELEASE ANY PROSPECTIVE CLAIM OF THE PARTICIPANT AGAINST THE TOWN, ITS OFFICERS, AND ITS EMPLOYEES FOR NEGLIGENCE, TO THE EXTENDED PROVIDED BY THE C.R.S. SECTION 13-22- 107(3), IN CONNECTION WITH THE ACTIVITIES. I UNDERSTAND THAT A DIGITALLLY SIGNED COPY OF THIS DOCUMENT TRANSMITTED BY EMAIL SHALL BE DEEMED TO HAVE THE SAME LEGAL EFFECT AS DELIVERY OF AN ORIGINAL SIGNATURE FOR THE PURPOSES OF VALIDITY, ENFORCEABILITY, AND ADMISSIBILITY.

Parent Signature

Clear

Date

If you are human, leave this field blank.

If completing this form electronically, it may be signed either by typing your name in the Signature field or by printing the form and signing by hand. The form will be sent automatically to FestivalontheFourth@gmail.com.

Volunteers will Not be asked to drive, or involved in Shuttling of patrons

Volunteers will be assigned a designated parking spot for the day of the event. Details will be release at Volunteer training 1 week prior to event.