I understand and am aware that my child’s participation in the City’s NextGenServe youth volunteer program (Program) with the City of Fort Collins involves inherent risks and hazards, including but not limited to, the risk of injury or exposure to viruses and other contagious diseases, as well as exposure to harmful substances, noxious weeds and proximity to animals, large vehicles, bodies of water or other similar circumstances. Recognizing those risks and hazards, I hereby give my consent and approval to my child’s participation in the Program.
I acknowledge that my child will:
1) be transported by vehicle to various locations around the City, which may include riding on the interstate; and
2) volunteer at farms, natural areas, rivers, ponds and gardens, which may result in close physical proximity to farm animals, Black Footed Ferrets, snakes, bugs, birds, dogs, cats, horses, fish, and all other wild animals; and
3) volunteer with various City departments that manage outdoor facilities and improvements, which may require using hand tools, paint, and other various tools; and
4) volunteer at City departments with and in proximity to large and fast-moving vehicles; and
5) volunteer at various locations where cleaning products will be in use, which may result in skin irritation, eye irritation, and allergic reactions; and
6) volunteer at an active kitchen where food will be handled, and cleaning products will be in use, which may result in choking, cuts, burns, falls, skin irritation, eye irritation, and allergic reactions; and
7) volunteer at local non-profits, all of which are different, but may require going to community members' houses, use of hand or power tools, and use of cleaning products; and
8) volunteer near and with children, which may result in injury or sickness; and
9) volunteer with various City departments that hold events open to the public, which will cause my child or me to be exposed to contagious diseases.
I understand that the risk of being injured or becoming exposed to harmful substances or infected by contagious disease may result from the actions, omissions, or negligence of my child and others, including, but not limited to, City employees, officials, volunteers, program participants, and their families. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that my child or I may experience or incur from participating in the Program.
In exchange for my child’s participation in the NextGenServe program, I release the City of Fort Collins, its officers, agents, volunteers and employees and agree to hold them harmless from any liability for any claim arising out of any injuries and/or damage to me, my child, my property, or loss of any other sort arising out of or related to activities with the Program, as a result of the negligence of the City of Fort Collins or any other person, including the risks associated with viruses and other contagious diseases. I agree to indemnify the City of Fort Collins, its officers, agents, volunteers and employees and to be responsible for all harm, injury or damage caused by my child to any persons, property or equipment in conjunction with the Program. I hereby give consent for emergency medical care prescribed by a medical professional. This care may be given under whatever conditions are necessary to preserve the well-being of my child.
Photo Release
City staff or other volunteers may take photos of volunteer activities for City marketing purposes unless a volunteer provides written notification to the City that he, she, or they do not authorize use of volunteer’s photos for this purpose.
Certification and Signature
I hereby certify and acknowledge that I am the legal guardian or parent of the child identified on this document. I am legally responsible for the child’s actions for damage to property or personal injury. I have read this document and have sufficient information to assess the risks and understand the effect of signing this document. By signing below, I give my consent and approval to my child’s participation and all other provisions noted above.
Child’s Full Name:____________________________ Guardian/Parent’s Name:____________________
Guardian/Parent’s Signature:_______________________________________Date:__________________