Volunteer Release and Waiver of Liability Form

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This Release and Waiver of Liability (the “release”) executed on __________ (date) by _________________________

(“Volunteer”) releases United Food Bank (also referred as UFB) a nonprofit corporation organized and existing under the

laws of the State of Arizona and each of its directors, officers, employees, and agents. The Volunteer desires to provide

volunteer services for UFB and engage in activities related to serving as a volunteer.

Volunteer understands that the scope of Volunteer’s relationship with UFB is limited to a volunteer position and that no

compensation is expected in return for services provided by Volunteer; the UFB will not provide any benefits traditionally

associated with employment to Volunteer; and that Volunteer is responsible for his/her own insurance coverage in the

event of personal injury or illness as a result of Volunteer’s services to UFB.

1. Waiver and Release: I, release and forever discharge and hold harmless UFB and its successors and assigns from

any and all liability, claims, and demands of whatever kind of nature, either in law or in equity, which arise or may

hereafter arise from the services I provide to UFB. I understand and acknowledge that this Release discharges United

Food Bank from any liability or claim that I may have against UFB with respect to bodily injury, personal injury, illness,

death, or property damage that may result from the services I provide to UFB or occurring while I am providing volunteer

services.

2. Insurance: Further I understand that United Food Bank does not assume any responsibility for or obligation to provide

me with financial or other assistance, including but not limited to medical, health, or disability benefits or insurance. I

expressly waive any such claim for compensation or liability on the part of UFB.

3. Medical Treatment: I hereby Release and forever discharge United Food Bank from any claim whatsoever which

arises or may hereafter arise on account of any first-aid treatment or other medical services rendered in connection with

an emergency during my tenure as a volunteer with UFB.

4. Assumption of Risk: I understand that the services I provide to United Food Bank may include activities that may be

hazardous to me including, but not limited to driving, lifting, pushing, pulling, use of cleaning chemicals, etc. involving

inherently dangerous activities. As a volunteer, I hereby expressly assume risk of injury or harm from these activities and

Release UFB from all liability.

5. Photographic Release: I grant and convey to United Food Bank all right, title, and interests in any and all photographs,

images, video, or audio recordings of me or my likeness or voice made by UFB in connection with my providing volunteer

services to UFB.

6. Other: As a volunteer, I expressly agree that this Release is intended to be as broad and inclusive as

permitted by the laws of the State of Arizona and that this Release shall be governed by and interpreted in accordance

with the laws of the State of Arizona. I agree that in the event that any clause or provision of this Release is deemed

invalid, the enforceability of the remaining provisions of this Release shall not be affected.

By signing below, I express my understanding and intent to enter into this Release and Waiver of Liability

willingly and voluntarily.

_______________________________________________ ____________________

Signature (Or parent/guardian if under 18) Date

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VOLUNTEER INFORMATION:

Name: __________________________________________________ Birthdate _________________________

Mailing Address ____________________________________________________________________________

City ___________________________________________State __________________ZIP _________________

Home Phone: _________________________Cell: _______________________ Work: ___________________

E-mail Address: ____________________________________________________________________________

Are you part of a group? Y N Company/group Name: ______________________________________________

Emergency Contact: ______________________________________________________________

Contact Relationship: ____________________ Emergency Phone Number: ___________________

Primary communication to volunteers is through the weekly notifications regarding UFB Volunteer Opportunities.

Would you like to receive this email about upcoming opportunities or our newsletters? Yes No.

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Volunteer Expectations Agreement

1. Volunteers working in any capacity within United Food Bank must be at least 5 years of age.

2. If any task causes you discomfort, or if you feel it is unsafe or unhealthy to perform a specific task, report the condition

to a food bank staff member immediately.

3. Wear sensible, appropriate clothing and footwear for the task(s) at hand.

*** Closed toed shoes are required for all warehouse activities. ***

4. Wash hands before beginning your shift, after eating, and after using the restroom.

5. Alcohol and other drugs are prohibited in the workplace.

6. No Smoking” policy – Smoking in designated area only.

7. Only authorized personnel may operate machines or equipment.

8. Report any injury immediately to United Food Bank staff on site.

9. No food, drink (exception to closed bottles of water), or cell phone use on the warehouse floor.

(if you must use your cell phone please relocate to an office or the volunteer area)

10. Please avoid conversations, comments and language that are inappropriate in a professional workplace.

11. Do not take any food from the food bank.

I have read the Volunteer Expectations Agreement _____ Yes

Signature ______________________________________ Date_________________________