I, as an adult age 18 or older, understand and agree that: · the information I have provided may be verified and I hereby give permission to Special Olympics Northern California, Inc. (“SONC”) to make inquiry of others concerning my suitability to act as a SONC volunteer. I understand this verification and inquiry may include my motor vehicle operation history (DMV) and criminal background check(s). Further, I hereby release all parties and persons from any and all liability for any damages, and voluntarily waive any and all rights, claims, charges, complaints, or causes of action I have or may have against SONC, including its directors, officers, employees, and representatives, and any consumer reporting agency SONC may engage, as a result of SONC’s and/or its representative’s actions in seeking, using, and/or disclosing information gained from a Consumer Report or Investigative Consumer Report about me, or any other background check or report about me, including but not limited to information gained from the state or federal Sexual Offender Identification Line/Registry or any other source;
· in consideration of participating in Special Olympics Unified Sports®, if applicable, I represent that I understand the nature of the event and that I am qualified, in good health, and in proper physical condition to participate in Unified Sports® events. I fully understand the event involves risks of serious bodily injury which may be caused by my own actions or inactions, by the actions of others participating in the event, or by conditions in which the event takes place. I fully accept and assume all such risks and all responsibility for losses, costs, and/or damages I may incur as a result of my participation. I acknowledge that at any time if I feel that the event conditions are unsafe, I will discontinue participation immediately;
· I release, indemnify, covenant not to sue, and hold harmless SONC, Special Olympics, Inc., their programs, administrators, directors, agents, officers, employees, and other volunteers and Unified Sports® participants, and sponsors, advertisers, and, if applicable, any owners and lessors of premises on which any activity takes place (“Releasees”) from all liability, any losses, claims (other than that of any medical accident benefit), demands, costs, or damages that I may incur as a result of participation as a volunteer and/or in Unified Sports® events and further agree that if, despite this “Release and Waiver of Liability” Agreement, I, or anyone on my behalf, makes a claim against any of the Releasees, I will indemnify, save, and hold harmless each of the Releasees from any litigation expenses, attorney fees, loss, liability, damage or cost which may incur as a result of such claim;
· if during my participation in Special Olympics activities I should need emergency medical treatment and I am not able to give my consent for or make my own arrangements for that treatment, I authorize SONC to take whatever measures are deemed necessary to protect my health and well-being, including, if necessary, hospitalization. My health insurer (and not any of the Releasees or their insurers) will be primarily responsible to pay for or otherwise cover any and all medically-related expenses incurred;
· in the course of volunteering for SONC I may be dealing with confidential information and I agree to keep said information in the strictest confidence; · the relationship between SONC and volunteers is an “at will” arrangement, and it may be terminated at any time without cause by either the volunteer or SONC;
· I must have and maintain at least the minimum amount of automobile insurance as required by the State of California. I agree to notify SONC if I do not have such coverage if at any time I am asked to use my personal or any non-owned vehicle for SONC related business or activities. Furthermore, I agree to not allow any person who does not have automobile insurance and SONC’s authorization to drive my vehicle for SONC related business or activities;
· I hereby grant SONC permission to use my likeness, voice, and words in or on television, radio, film, and SONC’s Website(s), or in any other form, format, or media, to promote the activities of or fundraising for SONC, without compensation; and
· I am responsible for informing SONC of ANY changes regarding information contained in this application, and I am responsible for following and abiding by the Coaches’ Code of Conduct as outlined in the attached handout.
I affirm that I have read this “Release and Waiver of Liability” Agreement, that I fully understand it, and that the information I have given is true. I understand that in the event any false information is provided, I may be terminated from my volunteer position with SONC and/or as a Special Olympics Unified Sports® participant.
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