Volunteer Liability Release Form

Earps, Inc
www.earps.org
PO Box 68477
Indianapolis, IN 46268
(317)809-2153

First Name: *
Last Name: *
Email *
How many hours are you planning to volunteer each week? *
What days are you available? *
Are there any animals you are not comfortable handling/caring for? *
Please list all minor children who may volunteer with you.
I give my voluntary consent to participation in an EARPS Inc. volunteer program beginning on the date below. I hereby release EARPS, Inc, board members, and volunteers from any and all liability while volunteering. In the event of an accident, injury, or illness, the above stated and its agents do not assume any responsibility or obligation to provide financial assistance or other assistance, including but not limited to, medical, health, or disability insurance, in the event of an accident, injury, illness, death or property damage. Furthermore, I release EARPs, Inc., their officers, and volunteers for any loss, personal injury, accident, misfortune, or damage to property of the above named, with the understanding that reasonable precautions shall be taken to ensure the health and safety of the above named volunteers.
Today's Date: *
Signature *