In consideration of being allowed to volunteer my services at the Samaritan Center, I hereby acknowledge that there are certain risks of injury involved, and I knowingly and freely assume all such risks and assume full responsibility for my participation. To the extent allowed by law, I agree to indemnify and hold harmless the Samaritan Center, its officers, employees, agents, representatives and volunteers, of all liabilities and all loss or damage to person or property which may occur or be incident to my involvement or participation. By submitting this form I am agreeing on behalf of myself or as a parent/guardian or supervisor of an individual or group of individuals under 18 years old.
I have read and fully understand the above application and the Volunteer Bill of Rights and Responsibilities and agree to comply with their contents.
