RELEASE OF LIABILITY: VOLUNTEER
Community Cycles of California (CCofCA) appreciates your time commitment in volunteering with our organization and we want to ensure that the experience is rewarding and productive for all participants. We ask that all volunteers follow the guidelines outlined below.

VOLUNTEER ACKNOWLEDGEMENT: I have agreed to volunteer for CCofCA  of my own free will, for my own personal purpose or pleasure.  I have done so without promise, expectation, or payment of wages, health benefits or any other forms of remuneration from CCofCA or any entity related to  CCofCA, and I acknowledge that CCofCA has not promised such payment, benefits, or other remuneration in any way.  I understand that I am not an employee or agent of CCofCA for any purpose and acknowledge that my services are not controlled nor mandated by  CCofCA  .
SAFETY RULES:
 
Listen to staff and lead volunteers
Leave work spaces clean when finished
Tools must stay onsite. Please do not take tools home or lend tools or parts to customers or clients.
Check that all tools are in the bag/on shelf when you start and finish work. Return bag at end of work.
Always return special tools when you have finished the task so others have use of them
Use proper safety and lifting techniques
If you need assistance, please ask for it
Running and shouting is prohibited
Please do not wear earbuds or other distractive devices
Wear close-toed shoes in retail and repair areas
Being under the influence of drugs or alcohol is not allowed. You will be asked to leave.
Report any hazards or safety issues to staff immediately
Treat people with respect and consideration
Have fun!

SHOP DUTIES AND HAZARDS: I am aware that working in the workshop or mobile workshop environment can be a potentially hazardous activity. Those hazards include, but are not limited to, injuries from slips and falls; back injuries from lifting and standing; and cuts. I am participating in these activities with the knowledge of the danger involved and therefore agree to personally accept, and be responsible for, all risks of injury or death. I understand that although CCofCA carries medical insurance, it is considered secondary coverage and my own health insurance is primary coverage.

WAIVER: As consideration for being permitted by CCofCA to participate in these activities and the use of their facilities, I hereby agree that I, my assignees, heirs, spouses, guardians, and legal representatives will not make a claim against, sue, or attach the property of CCofCA or any of its agents, directors, employees, representatives, contractors, or volunteers from injury or damage resulting from the negligence or other acts, however caused, by any agent, director, employee, representative, contractor or volunteer of CCofCA as a result of my participation as a program participant. I hereby furthermore release CCofCA and its agents, directors, employees, representatives, contractors, and volunteers from all actions, claims, or demands that I, my assignees, heirs, spouses, guardians, and legal representatives now have or may hereafter have from injury of damage, whether currently known or unknown, resulting from my participation as a volunteer. This release of liability and assumption of risk, in addition to covering any past occurrences, is intended to discharge in advance their respective successors and assigns from and against any and all liability arising out of or connected in any way with my participation as a volunteer of CCofCA, even though that liability may arise out of negligence or carelessness on the part of the persons or entities above mentioned, or any other cause.

I HAVE CAREFULLY READ THIS CONTRACT AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS VOLUNTEER ACKNOWLEDGEMENT AND LIABILITY WAIVER IS A CONTRACT BETWEEN MYSELF AND COMMUNITY CYCLES OF CALIFORNIA, AND I SIGN IT OF MY OWN FREE WILL. By signing, I agree to abide by the conditions outlined above.

Sign in to Google to save your progress. Learn more
Please initial to acknowledge: *
Date *
MM
/
DD
/
YYYY
First Name *
Last Name *
My email is: *
My phone number is:
My birthday is (year not needed) *
MM
/
DD
/
YYYY
Emergency Contact Name (First & Last) *
Emergency Contact Phone *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of communitycyclesca.org. Report Abuse